Multiple Family Groups for Children with Disruptive Behavior Disorders: Child Outcomes at 6-Month Follow-Up

Abstract

This paper reports on the 6-month follow-up outcomes of an effectiveness study testing a multiple family group (MFG) intervention for clinic-referred youth (aged 7–11) with disruptive behavior disorders (DBDs) and their families in socioeconomically disadvantaged families compared to services-as-usual (SAU) using a block comparison design. The settings were urban community-based outpatient mental health agencies. Clinic-based providers and family partner advocates facilitated the MFG intervention. Parent-report measures targeting child behavior, social skills, and impairment across functional domains (i.e., relationships with peers, parents, siblings, and academic progress) were assessed across four timepoints (baseline, mid-test, post-test, and 6-month follow-up) using mixed effects regression modeling. Compared to SAU participants, MFG participants reported significant improvement at 6-month follow-up in child behavior, impact of behavior on relationship with peers, and overall impairment/need for services. Findings indicate that MFG may provide longer-term benefits for youth with DBDs and their families in community-based settings. Implications within the context of a transforming healthcare system are discussed.

Multiple Family Groups to reduce child disruptive behavior difficulties: Moderating effects of child welfare status on child outcomes

“…Youth ages 7–11 were eligible to participate in the study if they met Diagnostic and Statistical Manual of Mental Health Disorders- fourth edition (DSM-IV) symptom criteria for Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD) (American Psychiatric Association, 2000). As reported in a prior manuscript (Gopalan et al, 2014), n = 96 potential participants were excluded from the study due to not meeting inclusion criteria (n = 91), declining to participate and not completing screening measures (n = 2), as well as those who were not appropriate for treatment or misreported as initially eligible (n = 3).…”

“…No significant differences in response rates were found for other assessment points by treatment condition. Additional details about study procedures are available in prior work (Chacko et al, 2014; Gopalan et al, 2014; McKay et al, 2011). …”

“…See Chacko et al, (2014) and Gopalan et al, (2014) for breakdown of services received by treatment condition.…”

“…MFG was designed to address shortages of available service providers in inner-city settings by having multiple families seen at time. A manualized curriculum with parsimonious and low-cost training and supervision strategies (Chacko et al, 2014; Gopalan et al, 2014; McKay et al, 2011) further increases ease of implementation. Finally, multiple strategies to address concrete (e.g., lack of transportation, child care, conflicting time demands) and perceptual (e.g., mental health stigma, prior negative service experiences) barriers to treatment (McKay & Bannon, 2004) promote treatment engagement for low-income families (McKay et al, 2011).…”

“…At post-test, experimental MFG participants manifested significantly reduced child behavioral difficulties and increased social skills compared to services as usual (SAU) control group participants (Chacko et al, 2014). At 6 months follow-up, experimental participants manifested significantly reduced child behavior difficulties, impact of child behavioral difficulties on children’s relationship with playmates, and overall severity of child behavioral difficulties and need for treatment (Gopalan et al, 2014). …”