Interventions for children and young people in the 'real-world'

Question 1

What makes a good therapeutic relationship?

Answer 1

A panel of experts concluded that several relationship elements were effective due to:

• Alliance in individual psychotherapy
• Alliance in youth psychotherapy
• Alliance in family therapy
• Cohesion in group therapy
• Empathy
• Collecting client feedback

Probably effective: goal consensus, collaboration, positive regard.

Question 2

Three other relationship elements

Question 3

Journal Club Study

Answer 3

• Primary Care Stepping Stones Positive Parenting Program
  
  • Participatory model’
    ]
    main mechanism for family and child outcomes
    Disruptive behaviours can be of comparable or greater concern to parents than the core symptoms of ASD

Addressing these behaviours within the first year of initial diagnosis holds great potential for improving persons functioning

Question 4

Acceptability

Answer 4

the extent to which the intervention is satisfying and suitable to participants

Question 5

Adaption

Answer 5

recommendations for program modifications

Question 5

Preliminary outcomes

Answer 5

whether the intervention produces the desired results

Question 6

Author’s conclusions of Journal Club

Answer 6

75% of parents completed 4 sessions with all reporting high levels of service satisfaction.

Preliminary results indicated clinically and statistically significant reductions in child maladaptive behaviours.

Question 7

Author’s conclusions of Journal Club: Design

Answer 7

Investigating preliminary outcomes, design with random assignment to the PC SS

Question 8

Author’s conclusions of Journal Club: Participants

Answer 8

• No differences in demographics across groups

Participants drawn from ASD clinics and community from one region

Most frequent parent nominated targeted behaviour was yelling and followed by tantrums, communication problems and not following directions

Child inclusion criteria consisted of receiving a DSM-5 (American Psychiatric Association, 2013) diagnosis within the past year

Medical record review indicated that a DSM-5 interview had been conducted for all children; 10 children had been administered the Autism Diagnostic Observation Schedule-2

Question 9

Author’s conclusions of Journal Club: Outcome measurement

Answer 9

average time between each of the four sessions was 12.86 days

Posttest measures were administered to all study parents

All parents received a twenty dollar gift card to a local discount retailer at the completion of each data collection point.

• Two parents were lost to follow-up in the intervention group. One parent was lost to follow-up in the waitlist group.

Question 10

Fidelity SS Triple P Client Satisfaction Questionnaire

Answer 10

Acceptability: 12-item semi-structured phone interview, delivered by a member of the study team

Question 11

Fidelity SS Triple P Client Satisfaction Questionnaire: Outcome measures

Answer 11

Eyberg Child Behavior Inventory, Parenting Sense of Competence Scale, Parenting Stress Index-Short Form, the Behavior Control Subscale of the Family Assessment Device

Question 12

Fidelity SS Triple P Client Satisfaction Questionnaire: Preliminary Outcomes

Answer 12

Intervention group reported:
- Reductions in child externalising behaviour intensity
- Reductions in parenting stress
- Increases in parenting competence and family functioning

Qualitative – Implementation barrier

Question 13

Fidelity SS Triple P Client Satisfaction Questionnaire: Strengths of Preliminary Outcomes

Answer 13

learning how to identify behavioural antecedents, practitioner attunement, services to be immediately extended

• Change in number of child behaviour problems trended toward significance.