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Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice
1Institute of Psychiatry, King's College London, London SE5 8AF. s.scott@iop.kcl.ac.uk
Insights
A behaviorally based parenting program significantly reduced antisocial behavior in young children. This effective treatment, delivered in clinical settings, offers a promising approach for managing childhood behavioral issues.
Area of Science:
- Child Psychology
- Behavioral Therapy
- Clinical Psychiatry
Background:
- Antisocial behavior in children is a significant concern with long-term implications.
- Effective interventions delivered in real-world clinical settings are crucial for widespread impact.
Purpose of the Study:
- To evaluate the effectiveness of a behaviorally based group parenting program for treating antisocial behavior in children.
- To assess the program's efficacy within regular child and adolescent mental health services.
Main Methods:
- A controlled trial with a permuted block design was conducted.
- 141 children (aged 3-8) with antisocial behavior were allocated to either a parenting group (90) or a waiting list control (51).
- The Webster-Stratton parenting program, a 13-16 week videotape-based intervention, was administered to parents.
Main Results:
- Children in the intervention group showed a significant reduction in antisocial behavior (effect size 1.06 SD, P<0.001).
- Parents in the intervention group increased praise and decreased ineffective commands threefold, while control parents showed the opposite trend (effect size 0.76, P=0.018).
- An intention-to-treat analysis, including children lost to follow-up, showed a reduced but still significant effect size.
Conclusions:
- Group parenting programs are effective in reducing serious antisocial behavior in children under real-life conditions.
- The findings support the use of this parenting program in routine clinical practice.
- Further follow-up is recommended to assess long-term outcomes, including prognosis and prevention of future criminality.
Objective:
To see whether a behaviourally based group parenting programme, delivered in regular clinical practice, is an effective treatment for antisocial behaviour in children.
Design:
Controlled trial with permuted block design with allocation by date of referral.
Setting:
Four local child and adolescent mental health services.
Participants:
141 children aged 3-8 years referred with antisocial behaviour and allocated to parenting groups (90) or waiting list control (51).
Intervention:
Webster-Stratton basic videotape programme administered to parents of six to eight children over 13-16 weeks. This programme emphasises engagement with parental emotions, rehearsal of behavioural strategies, and parental understanding of its scientific rationale.
Main Outcome Measures:
Semistructured parent interview and questionnaires about antisocial behaviour in children administered 5-7 months after entering trial; direct observation of parent-child interaction.
Results:
Referred children were highly antisocial (above the 97th centile on interview measure). Children in the intervention group showed a large reduction in antisocial behaviour; those in the waiting list group did not change (effect size between groups 1.06 SD (95% confidence interval 0.71 to 1.41), P<0.001). Parents in the intervention group increased the proportion of praise to ineffective commands they gave their children threefold, while control parents reduced it by a third (effect size between groups 0.76 (0.16 to 1.36), P=0.018). If the 31 children lost to follow up were included in an intention to treat analysis the effect size on antisocial behaviour was reduced by 16%.
Conclusions:
Parenting groups effectively reduce serious antisocial behaviour in children in real life conditions. Follow up is needed to see if the children's poor prognosis is improved and criminality prevented.