Enhancing adoptive parenting: A randomized controlled trial

Rushton, Alan; Monck, Elizabeth; Leese, Morven; McCrone, Paul; Sharac, Jessica

doi:10.1177/1359104510365041

Cited by 26 publications

(74 citation statements)

References 17 publications

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“…Six papers [619][620][621]623,626,628 were excluded because they did not involve an intervention and four papers 587,618,624,625 because the intervention in question did not meet criteria for inclusion, focusing on prevention rather than treatment. Two records 622,627 did not have a specific focus on maltreatment, three records 116,504,588 did not meet criteria for a full economic evaluation and one record 617 was a conference abstract.…”

Section: Excluded Economic Studiesmentioning

confidence: 99%

“…A total of 16 papers 116,504,587,588,[617][618][619][620][621][622][623][624][625][626][627][628] were excluded from the review of economic evidence and these are reported in Table 10. Six papers [619][620][621]623,626,628 were excluded because they did not involve an intervention and four papers 587,618,624,625 because the intervention in question did not meet criteria for inclusion, focusing on prevention rather than treatment.…”

Section: Excluded Economic Studiesmentioning

confidence: 99%

“…CBT for children with maltreatment histories, including those with experience of multiple forms of maltreatment and those that recruit children irrespective of type of maltreatment history. [110][111][112][114][115][116][117]121,176 Description of studies…”

Section: Cognitive-behavioural Therapymentioning

confidence: 99%

“…We identified 26 controlled studies [90][91][92][93][94][95][96][97][98][99][100][101][102][103][106][107][108][109][110][111][112][114][115][116][117]121,176,268 of cognitive-behavioural interventions (CBT), of which 23 were randomised trials. There were sufficient randomised trials to attempt to explore the differential effect on different maltreatment histories, broadly defined, and so this section is organised into the following three groupings, and does not include the three COSs of CBT interventions.…”

Section: Cognitive-behavioural Therapymentioning

confidence: 99%

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The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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BackgroundChild maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.ObjectivesTo synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.Study designFor effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.ParticipantsChildren and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.InterventionsAny psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.Main outcome measuresPsychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.MethodsYoung Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.ResultsWe identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive–behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) –0.44 (95% CI –4.43 to –1.53)], depression [mean difference –2.83 (95% CI –4.53 to –1.13)] and anxiety [SMD –0.23 (95% CI –0.03 to –0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist–child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.ConclusionsIt is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.LimitationsStudies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.Future workStudies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.Study registrationThis study is registered as PROSPERO CRD42013003889.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Excluded Economic Studiesmentioning

confidence: 99%

Section: Excluded Economic Studiesmentioning

confidence: 99%

Section: Cognitive-behavioural Therapymentioning

confidence: 99%

Section: Cognitive-behavioural Therapymentioning

confidence: 99%

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The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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“…It has been challenging for adoptive parents to access appropriate support (Rushton, Monck, Leese, McCrone, & Sharac, 2010) and it has been unclear which are likely to be the best models for intervention as children's problems can seem entrenched. A recent randomised controlled trial comparing two models of parenting intervention for adoptive families suggested that adoptive parents "had greater capacity to change than the children" (Rushton et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental problems in maltreated children referred with indiscriminate friendliness

Kočovská

Puckering

Follan

et al. 2012

Research in Developmental Disabilities

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We aimed to explore the extent of neurodevelopmental difficulties in severely maltreated adopted children. We recruited 34 adopted children, referred with symptoms of indiscriminate friendliness and a history of severe maltreatment in their early childhood and 32 typically developing comparison children without such a history, living in biological families. All 66 children, aged 5-12 years, underwent a detailed neuropsychiatric assessment.The overwhelming majority of the adopted/indiscriminately friendly group had a range of psychiatric diagnoses, including Attention Deficit Hyperactivity Disorder (ADHD), PostTraumatic Stress Disorder (PTSD) and Reactive Attachment Disorder (RAD) and one third exhibited the disorganised pattern of attachment. The mean IQ was 15 points lower than the comparison group and the majority of the adopted group had suspected language disorder and/or delay. Our findings show that school-aged adopted children with a history of severe maltreatment can have very complex and sometimes disabling neuropsychiatric problems.

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Parenting interventions to support parent/child attachment and psychosocial adjustment in foster and adoptive parents and children: A systematic review

Dalgaard

Filges

Viinholt

et al. 2022

Campbell Systematic Reviews

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Background: Adopted children and children placed in foster care are at increased risk of developing a range of mental health, behavioural, and psychosocial adjustment problems. Previous studies suggest that due to early experiences of separation and loss some children may have difficulties forming a secure attachment relationship with the adoptive/foster parents.Objectives: The objectives of the present review were: (1) to assess the efficacy of attachment-based interventions on measures of favourable parent/child outcomes (attachment security, dyadic interaction, parent/child psychosocial adjustment, behavioural and mental health problems, and placement breakdown) within foster and adoptive families with children aged between 0 and 17 years. (2) to identify factors that appear to be associated with more effective outcomes and factors that modify intervention effectiveness (e.g., age of the child at placement and at intervention start, programme duration, programme focus).Search Methods: Relevant studies were identified through electronic searches of bibliographic databases, governmental and grey literature repositories, hand search in specific targeted journals, citation tracking, contact to international experts and Internet search engines. The database searches were carried out to October 2020. SelectionCriteria: The interventions of interest were parenting interventions aimed at helping the foster/adopted children and their parents to form or sustain a secure attachment relationship. The interventions had to be at least partly informed by attachment theory. Data Collection and Analysis: The total number of potentially relevant studies constituted 17.822 hits after duplicates were removed. A total of 44 studies (27 different populations) met the inclusion criteria and were critically appraised by the review authors. Due to critical study quality, missing numeric data and re-use of the same data, only 24 studies analysing 16 different populations could be used in the data synthesis (children, N = 1302; parents, N = 1344). Meta-analysis using both child and parent outcomes were conducted on each metric separately. All analyses

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Enhancing adoptive parenting: A randomized controlled trial

Cited by 26 publications

References 17 publications

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Neurodevelopmental problems in maltreated children referred with indiscriminate friendliness

Parenting interventions to support parent/child attachment and psychosocial adjustment in foster and adoptive parents and children: A systematic review

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