The current project aims first to examine whether IPT produces outcomes that are superior to the comprehensive treatments already available ('care as usual'). Primary outcomes include parenting behavior and the quality of the parent-child…
Source
Brief title
Condition
- Other condition
Synonym
Health condition
probleemgedrag van ouders en/of kinderen
Research involving
Sponsors and support
Intervention
No registrations found.
Outcome measures
Primary outcome
Information will be obtained by using multiple sources of information (parents,
therapist, teacher, and child, if older than 9 years) and multiple methods
(questionnaires, interviews and observations).
All of the instruments are well-established, have been used often both in the
USA and in the Netherlands and have excellent psychometric properties.
Primairy outcomes:
1. parental behavior:
-Parental Dimensions Inventory (Thomas and Power, 1987) : responsiveness,
support and consistency;
-harsh discipline (Fuligny & Eccles, 1993)
-psychological control (Steinberg et al. 1992 and Barber, 1996)
-behavioral control (Barber, 1996 ) and
-in only 30 families: observations with revealed differences task (parent-child
discussion: rating scales of the above mentioned dimensions of child rearing)
2. quality of the parent-child relation
-Conflictscale (Dekovic, 1999)
-acceptance scale of Parental Stress Index (PSI) (Abidin, 1983)
-attachment to the child (PSI- Abidin, 1983)
-attachment to the parents (Inventory of Parent Attachment)
-Communication with parents (Olweson, 1990).
Secondary outcome
Secundary outcomes:
1. problem behavior of the child (CBCL-parent, YSR-child if at least 9 years
old, TRF-teacher),
2. academic competence of the child (teacher report of school attendance,
GPA),
3. social competence of the child (CBSK reported by parent and child).
To answer the second research question (mediation):
parental beliefs (Effects on development- Dekovic 1996) and parental confidence
(PSI-competencescale (Abidin-1983).
To answer the third research question (moderation):
characteristics of the participants (demographics, initial level of problems,
parental psychopathology (ASR-Achenbach), and characteristics of the treatment
(location, number of completed sessions, Quality of the therapist- education
and experience, satisfaction with the treatment, treatment adherence.
Background summary
Many of the treatments available for multiproblem families have never been
properly evaluated in the Netherlands, and thus non-evaluated treatments
continue to dominate the field. This fact has been repeatedly emphasized as an
important obstacle in development and refinement of evidence-based
interventions in Dutch Youth Care. The present study focuses on Intensieve
Pedagogische Thuishulp (IPT), an intensive home-based treatment for families
with school age children, who experience multiple problems. Recently, IPT has
been implemented in Bureau Youth Care Flevoland. The IPT can be labeled as
promising because it incorporates several characteristics that have been shown
to increase the effectiveness: it is multi-faceted, intensive, strength-based
treatment and the services are delivered to families in their own homes.
Indeed, recent meta-analysis of home visiting programs in the USA showed that
parents received benefit from home visits in terms of their parenting attitudes
and behavior and children in families who were enrolled in home visiting
programs fared better than did control group children. It must be pointed out,
however, that there are many differences between the USA and The Netherlands in
organization of mental health services, availability of different treatments,
type of clients etc., so the question remains whether these positive results
will be obtained here. Although there has been some evaluation of similar
interventions in The Netherlands, the poor quality of most studies' designs
does not allow reliable and valid conclusions about effectiveness of these
interventions.
Study objective
The current project aims first to examine whether IPT produces outcomes that
are superior to the comprehensive treatments already available ('care as
usual'). Primary outcomes include parenting behavior and the quality of the
parent-child relationship. Secondary outcomes include child problem behavior,
social and academic competence.
A large body of treatment-effectiveness studies has focused solely on pragmatic
goals (i.e. whether the treatment is effective), devoting little attention to
how and for whom interventions yield beneficial outcomes. The present study
aims to go beyond the simple effectiveness question. Second aim therefore is to
examine the processes through which the IPT works by testing the hypothesized
mediators of beneficial treatment. These treatment mediators are suggested by
theoretical models that provide a conceptual basis of IPT. For parenting
(primary) outcomes mediators include changes in parental beliefs and an
increase in parental confidence, whereas for the child (secondary) outcomes,
mediators are improvements in parenting behavior and the parent-child
relations.
Third aim is to determine circumstances in which IPT yield beneficial outcomes
by examining possible treatment moderators: characteristics of participants and
characteristics of treatment.
Study design
Randomized clinical trial will be conducted, including pretest-posttest control
group design, randomized assignment to conditions (IPT vs. control group - care
as usual,CAU) and a long term follow up. Each treatment condition (IPT and CAU)
will include 144 multiproblem families. Pretest assessment (T1) will take place
immediately prior to the beginning of treatment, posttest assessment (T2) will
take place immediately after treatment (on average 12 months), and follow up
(T3) will be conducted 6 months after the end of treatment. The identical
assessment battery will be administered to both groups at T1, T2, and T3. The
assessment will include multi methods (interviews, questionnaire, observation)
and multi sources of information (parent, child, therapist, observer, teacher).
In addition, to examine the processes of change (see Aims 2) a two-monthly
assessment will take place in IPT group only. Through telephone interviews
information will be obtained from participants and from the therapists on
several central concepts of this study.
Intervention
Families are random assigned to treatments already available: care as usual of
Intentive home visiting.
Study burden and risks
Families, teachers and therapists mainly fill in questionnaires at the start
and the end of treatment and at follow-up. These questionnaires are already
frequently used in research and in clinical practice. The burden of giving
information is limited. The only risk is that filling in questionnaires about
parenting and the child will lead to additional requests for assistance. This
risk is small. Since families receive treatment we expect minimal adverse
effects. Benefit of the study is being able to select and offer evidence-based
effective treatments.
Heidelberglaan 1
3508 TC Utrecht
NL
Heidelberglaan 1
3508 TC Utrecht
NL
Listed location countries
Age
Inclusion criteria
The inclusion criteria are: (1) child age between 4 and 18 years, (2) multiple problems in the family (based on diagnostic information from clinicians), (3) parents (or care givers ) are sufficiently motivated to start treatment.
Exclusion criteria
referral to other organisations than the four participating organisations
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
CCMO | NL11061.041.06 |
NTR-old | NTR1375 |