Linking empirically based theory and evaluation: The family bereavement program

Conclusion We have illustrated how our small theory (Lipsey, 1990) of bereavement guided the development and evaluation of a preventive intervention for bereaved children. Our small theory, based on prior empirical research, enabled us to identify family processes that appeared to mediate the effects of parental death on child mental health. Our intervention was designed to attempt to change these processes. The evaluation of our experimental trial of the intervention assessed changes on these processes as well as the more distal mental health outcomes. The experimental trial showed some-what encouraging results, in terms of the program's ability to modify the warmth of the parent–child relationship and to decrease symptomatology in the adolescent children. We also obtained further empirical support for our underlying theoretical model. Finally, implications for redesign of the program were derived from assessing the adequacy of the program components to change each of the mediators in the theoretical model.Support for this research was provided by NIMH grant P5OMH39246 which is gratefully acknowledged. David R. Pillow is now at Western Psychiatric Institute, Pittsburgh; Fred Rogosch is at the University of Rochester; Janette Beals is now at University of Colorado Health Sciences Center; Kim D. Reynolds is now at the University of Alabama, Birmingham; Carl Kallgren is now at the Pennsylvania State University, at Erie; and Rafael Ramirez is now at the University of Puerto Rico.     

Implementation of an empirically based drug and violence prevention and intervention program in public school settings

Describes the implementation of a collaborative preventive intervention project (Healthy Schools) designed to reduce levels of bullying and related antisocial behaviors in children attending two urban middle schools serving primarily African American students. These schools have high rates of juvenile violence, as reflected by suspensions and expulsions for behavioral problems. Using a quasi-experimental design, empirically based drug and violence prevention programs, Bullying Prevention and Project ALERT, are being implemented at each middle school. In addition, an intensive evidence-based intervention, multisystemic therapy, is being used to target students at high risk of expulsion and court referral. Hence, the proposed project integrates both universal approaches to prevention and a model that focuses on indicated cases. Targeted outcomes, by which the effectiveness of this comprehensive school-based program will be measured, are reduced youth violence, reduced drug use, and improved psychosocial functioning of participating youth.     

An evaluation of a behavioural parenting intervention for parents of gifted children

Parents of gifted children identify a need for tailored parenting support, and gifted children have unique requirements and vulnerabilities. The aim of this study was to assess the efficacy of a tailored behavioural parenting intervention, for enhancing the parenting skills of parents of gifted children and to assess the effect of these changes on the behavioural and emotional adjustment of their gifted child. A randomised controlled trial of tailored Group Triple P – Positive Parenting Program was conducted with 75 parents of children identified as gifted. Results indicated significant intervention effects for the number and frequency of parent reported child behaviour problems, as well as hyperactivity in the intervention group, relative to a waitlist control. Parents also reported significant improvements in their own parenting style, including less permissiveness, harshness, and verbosity when disciplining their child. No intervention effects were evident for teacher reports, except for a trend in relation to hyperactivity. This study demonstrated that a tailored behavioural parenting intervention is effective and acceptable for parents of gifted children, and thus has clinical implications for the delivery of parenting interventions for this population.     

School-based discussion groups for children of divorce: A pilot program

This paper describes a pilot program for school-based discussion groups for children of divorce. Relevant literature is reviewed and a model for a semistructured discussion group for latency-aged children is presented. Particular techniques used to engage children in discussion of relevant issues are described. While we have not conducted a systematic outcome study of these groups, our impression is that while some definite concrete changes have occurred for several children, for others, change has been located more in the representational than behavioral world. Children may remain unable to communicate angry feelings to the absent parent but as a result of the group experiences may be able to stop thinking of themselves as bad for harboring such feelings in the first place.Formerly an Elementary Guidance Counselor in the Brookline Public Schools, currently is an Educational Consultant in the Philadelphia area.     

Development and description of an empirically based ecobehavioral treatment program for child maltreatment

Victims of child maltreatment and their families evince a myriad of behavioral problems, including deficits in parenting skills, social skills, safety skills, anger, stress, and financial management, mood disorders, and abusive behavior. Controlled treatment outcome studies in child maltreated samples have indicated that many of these problems are responsive to clinical intervention strategies. However, empirically based practitioners who treat child maltreatment are faced with the inevitable task of effectively integrating these treatments into their clinical programs. Therefore, this paper describes the development of an ecobehavioral treatment program for child maltreatment that is founded on a comprehensive integration of previously validated procedures. The program's development, and methods of assessment and intervention, will be underscored, including therapist training strategies, and solutions to problems that sometimes occur. Data in support of the program is examined, but primarily as a means to demonstrate how evaluative components may be utilized in practice settings to guide intervention. Copyright © 1999 John Wiley & Sons, Ltd.     

Preventive intervention with latency-aged children of divorce: A replication study

This replication study assessed the efficacy of a school-based preventive intervention for latency-aged children of divorce. The Children of Divorce Intervention Program (CODIP) emphasizes support, identifying and expressing divorce-related feelings, training situationally relevant communication, problem solving, and anger control skills, and enhancing self-esteem. Fifty-four children of divorce participated in the 11-session program conducted in small groups. Their adjustment was contrasted at pre and post with that of demographically matched peers (N = 78) from intact families on teacher, parent, self-report, and group leader measures. Children of divorce were less well adjusted than their peers before the intervention. They improved significantly after the intervention, approaching youngsters from intact families in adjustment status. The replication data support CODIP's efficacy as a preventive alternative for children of divorce. Needed future development and research steps are considered.     

Evaluating a primary prevention program for children of divorce

The effectiveness of a primary prevention program for children of divorce is evaluated. Subjects included 82 mother-child pairs. Mothers had been separated for 33 months or less and did not have prior histories of using mental health services. Subjects were assigned to one of four conditions: (a) the Children's Support Group alone (CSG), (b) the CSG and the Single Parents' Support Group (SPSG), (c) the SPSG alone, or (d) a no-treatment control group. Data collected before, after, and 5 months following intervention, were analyzed using analyses of covariance with preintervention scores as covariates and pre-post and post-follow-up difference scores as dependent measures. Children in the CSG-alone condition improved most in self-concept and parents in the SPSG-alone condition improved the most in adjustment. Improvements were either maintained or did not change differentially across groups at follow up. Adaptive social skills of CSG-alone children compared to children in the CSG/SPSG groups showed significant post-to-follow-up improvements.     

The evaluation of an intervention program for young schoolchildren with acting-out problems

The rationale and nature of a program to train nonprofessional child-aides for helping interactions with young acting-out school children are described. Pre/ post teacher measures of children's problems and competencies, aide measures of problem behavior, and school mental health professionals' change in behavior estimates were used to evaluate the program's effectiveness. Children seen by trained aides showed significantly greater reductions both in acting-out problems and in overall maladjustment than did similar children seen by comparable aides who did not have additional training, or by themselves before training. Implications were considered for optimizing outcomes both in the specific school intervention project in question and in other, broader types of clinical interventions.This study was supported by a grant from the NIMH Experimental and Special Training Branch (MH 14547-02), which the authors acknowledge with gratitude. Our thanks also go to Bruce Rapkin and Mary Boike, who assisted in the data analyses.     

The additive and interactive effects of parenting and temperament in predicting adjustment problems of children of divorce

Investigated the interaction between parenting and temperament in predicting adjustment problems in children of divorce. The study utilized a sample of 231 mothers and children, 9 to 12 years old, who had experienced divorce within the previous 2 years. Both mothers' and children's reports on parenting, temperament, and adjustment variables were obtained and combined to create cross-reporter measures of the variables. Parenting and temperament were directly and independently related to outcomes consistent with an additive model of their effects. Significant interactions indicated that parental rejection was more strongly related to adjustment problems for children low in positive emotionality, and inconsistent discipline was more strongly related to adjustment problems for children high in impulsivity. These findings suggest that children who are high in impulsivity may be at greater risk for developing problems, whereas positive emotionality may operate as a protective factor, decreasing the risk of adjustment problems in response to negative parenting.     

Transportability of an empirically supported dissonance-based prevention program for eating disorders

This study sought to evaluate the degree to which positive effects remained when a well studied cognitive dissonance eating disorder prevention program was disseminated through a large national sorority under naturalistic conditions. All participants underwent a 2-session program run by peer facilitators. The sample included 182 undergraduate women from a local chapter of a national sorority at a large public university. Analyses revealed that the program significantly reduced body dissatisfaction, thin ideal internalization, dietary restraint, and the use of the media as a source of information about beauty, and restrained eating. Importantly, effect sizes were maintained at 5-months and 1-year follow-up. These findings demonstrate that empirically supported programs can remain effective when disseminated with careful training in large social systems.     

Evaluating an innovative counselling service for children of divorce

An evaluation of the first counselling service in Britain for children of divorce is reported. In a previous article, the quantitative outcomes of counselling were outlined, which included such data as the children's self-esteem and perceptions of divorce. Here the focus is on the qualitative outcomes of the counselling evaluation: namely, the children's and mother's satisfaction with the counselling, and the counsellor's opinion of its success. The conclusions of the study and their implications for practice are discussed.     

Interpersonal problem solving: An intervention program for preschool children

The purpose of the present study was to evaluate the effectiveness of an intervention program designed to train preschool children in interpersonal problem solving skills. Forty preschool age children were randomly assigned to an experimental or control group. Experimental subjects were trained in interpersonal problem solving skills for ten weeks, four days per week, for a total of 10–13 hours. Problem-solving skills were assessed at pretest, posttest, and three months after training was completed. Seventy-eight percent of the children who participated in pretest and posttest were tested at follow-up. Results indicated that the experimental group, compared to the control group, showed a significant increase in both cognitive—verbal and behavioral interpersonal problem-solving skills from pretest to posttest and that these changes were maintained at follow-up testing. Discussion focuses on suggestions for future research and implications for applied settings.     

Pretend play: an application of an intervention program in autism

Methodologically and theoretically based on metarrepresentational deficit hypothesis, we design an intervention to teach the mental state of pretense to an autistic boy. The production and comprehension of symbolic play by means of the use of two specific strategies founded on pictorial analogy of the mental representation and process, was the focus of the learning. The efficiency and efectiveness of the program is reflected in the results that indicated the subject's competence to generate and comprehend the pretense as well as to generalize the acquired knowledge into other areas of mentalistic functioning. We discuss the possibility to develop a metarrepresentational knowledge based on the internalizing of the strategies of conceptual support.     

Reporting a program evaluation: Needs,program plan,intervention, and decisions

The approach to intervention programs varies depending on the methodological perspective adopted. This means that health professionals lack clear guidelines regarding how best to proceed, and it hinders the accumulation of knowledge. The aim of this paper is to set out the essential and common aspects that should be included in any program evaluation report, thereby providing a useful guide for the professional regardless of the procedural approach used. Furthermore, the paper seeks to integrate the different methodologies and illustrate their complementarity, this being a key aspect in terms of real intervention contexts, which are constantly changing. The aspects to be included are presented in relation to the main stages of the evaluation process: needs, objectives and design (prior to the intervention), implementation (during the intervention), and outcomes (after the intervention). For each of these stages the paper describes the elements on which decisions should be based, highlighting the role of empirical evidence gathered through the application of instruments to defined samples and according to a given procedure.     

A 1-year follow-up study of children's divorce adjustment,custodial mothers' divorce adjustment,and postdivorce parenting

This study examined stability of and change in divorce adjustment in a sample of 20 white custodial mothers and their children (8 boys, 12 girls; mean age = 10.45 years) who were examined an average of 12.85 months after separation and again one year later. Pearson correlations generally revealed moderate stability in children's adjustment, mothers' adjustment, and parenting dimensions. Significant changes over the one-year period were found only with respect to children's beliefs about the divorce: problematic beliefs regarding peer ridicule and avoidance, fear of abandonment, and self-blame decreased over the 1-year period. Children's adjustment at Time 2 was related to the following variables assessed at Time 1: low rhythmic and low reactive child temperaments; children's mature understanding of conflict resolution; high social support for children and for mothers; low maternal stress; high maternal adjustment; cooperative parenting; high paternal involvement; and frequent visitation by and phone contact from the fathers. Children with few problematic beliefs at Time 2 regarding fear of abandonment and hope of reconciliation had mothers who functioned poorly at Time 1. Although the small sample size necessitates that the findings be viewed with caution, they support the view that children's divorce adjustment is related to children's own competencies, intrafamilial processes, and extrafamilial conditions.     

Personality disorder not otherwise specified: searching for an empirically based diagnostic threshold

The purpose of this paper is to propose a method for empirically investigating diagnostic criteria for personality disorder not otherwise specified (PDNOS). From a large, nonclinical sample of military recruits and undergraduate students who were screened for personality disorders (PDs), 572 completed the Structured Interview for DSM-IV Personality. Data from the interviewed group were used to identify a diagnostic threshold for PDNOS by comparing those who did (n = 88) and did not (n = 484) qualify for a PD diagnosis. For both groups, subjective distress increased and measures of social and occupational functioning decreased as a function of the number of PD criteria met. A classification and regression tree modeling procedure was applied using self-report scores on measures of mood, anxiety, and personality traits to arrive at probabilities for predicting the presence of a PD diagnosis based on the pattern of reported traits present. These probabilities were then used to derive an empirically based diagnostic threshold for PDNOS. In this sample, the most appropriate threshold for a PDNOS diagnosis appears to be the presence of 10 PD criteria for a person who does not qualify for a diagnosis of any other specific form of PD. This definition identified 5.5% of the young adults who were interviewed in this study.     

Toward an empirically based parameter selection for time-sampling observation systems

The measurement error of time-sampling observation systems, used to estimate the frequencyof behavioral events, was analyzed by means of a five-factor design, computer simulation experiment. The first three factors represented response parameters: the relative frequency and duration of the behavior and the pattern of response distribution. For each combination of frequency, pattern, and duration, five simulated behavior events were generated within a simulated observation period of 900 sec. A total of 21 different time-sampling systems was employed. As a fourth factor three different observe and record lengths were included (6, 12, and 60 sec). In addition, there were seven different ratios of “observe” to “record” interval length (5∶1, 3∶1, 2∶1, 1∶1, 1∶2, 1∶3, and 1∶5) representing the fifth factor. Thus, 21 time-sampling systems scanned a total of 120 different behavior simulations from 24 types of behavior parameter combinations. The data were analyzed by means of a five-factor (2 × 3 × 4 × 3 × 7) analysis of variance with repeated measures on two factors. The study demonstrated that time sampling leads to high average measurement errors, which are determined by complex interrelationships among a variety of variables. Choosing a time-sampling system arbitrarily may lead to highly erroneous data. It was also shown, however, that time-sampling systems have the potential to yield very accurate results. An empirical selection procedure for time-sampling intervals is proposed to minimize measurement error. Exemplary tables are presented from which time-sampling parameters can be chosen given that the rate, duration, and pattern of occurrence of a behavior to be observed are known.