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Beyond Jacobson and Truax: Estimation of Clinical Significance Trajectories in the Coping Power Intervention Using
Antonio A Morgan-López1, Lissette M Saavedra1, Heather L McDaniel2
1RTI International.
Behavior Therapy
|April 26, 2025
Summary
Individually delivered Coping Power (CP) significantly improved child externalizing problems more than group CP. Advanced analysis revealed higher individual improvement rates and fewer negative outcomes with ICP, enhancing intervention precision.
Area of Science:
- Child Psychology
- Intervention Science
- Statistical Modeling
Background:
- Coping Power (CP) is a preventive intervention targeting child externalizing problems.
- Group CP (GCP) is common, but individual CP (ICP) shows greater mean reductions in externalizing problems.
- Standard randomized trial analysis overlooks individual change trajectories.
Purpose of the Study:
- To compare clinically significant change (CSC) in externalizing problems between ICP and GCP.
- To apply a novel measurement error-corrected multilevel modeling method for CSC assessment.
- To develop an individual-level effect size metric for CSC to address Type II errors.
Main Methods:
- Secondary analysis of a 360-participant ICP/GCP trial.
- Utilized a novel CSC method with measurement error correction and multilevel modeling.
- Developed and applied an individual-level effect size metric (Cohen's d) for CSC.
Main Results:
- Significantly more youth in ICP (73%) showed clinically significant improvement (d ≥ 0.5) in externalizing problems compared to GCP (45%).
- GCP had a higher percentage of youth experiencing worsening externalizing problems.
- Half the sample showed non-statistically significant improvement exceeding d ≥ 0.5, indicating potential Type II errors in traditional CSC.
Conclusions:
- ICP demonstrates superior individual-level effectiveness in reducing child externalizing problems compared to GCP.
- Advanced CSC analysis provides more nuanced insights into intervention outcomes than standard randomized controlled trial analyses.
- Novel CSC methodologies enhance precision in estimating individual-level intervention effects.
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