Treating Mothers of Aggressive Children: A Research Study

A Brief History of Group Therapy as a Field and the Representation of Women in Its Development

This article explores the place of women in the specialization of group psychotherapy, particularly their representation in journal publications, both in topical coverage related to women as well as in editorial participation and leadership. We first present a brief history of group psychotherapy to provide overall context. Next, we present major cross-cutting themes related to women and group work that emerged from our review of nine peer-reviewed journals deemed most relevant to our investigation. We end with observations and a call for greater inclusion of women in the group psychotherapy literature.

How can adolescent aggression be reduced? A multi-level meta-analysis

Aggressive behaviour among adolescents has significant social and economic costs. Numerous attempts have been made to intervene to reduce aggression in adolescents. However, little is known about what factors enhance or diminish intervention effectiveness. The present systematic review and meta-analysis, therefore, seeks to quantify the effectiveness of interventions to reduce aggressive behaviour in adolescents and to identify when and for whom such interventions work best. Sixteen databases were searched for randomised controlled trials that assessed interventions to reduce aggression among adolescents. After screening 9795 records, 95 studies were included. A multi-level meta-analysis found a significant overall small-to-medium effect size (d = 0.28; 95% CI [0.17, 0.39]). More effective interventions were of shorter duration, were conducted in the Middle East, were targeted at adolescents with higher levels of risk, and were facilitated by intervention professionals. Potentially active ingredients were classified using the Behaviour Change Technique Taxonomy. Behavioural practice and problem solving were components of more effective interventions targeted at the general population. Overall the findings indicate that psychosocial interventions are effective in reducing adolescent aggression. Future trials need to assess the effect of individual techniques and their combination to identify the key components that can reduce aggression in adolescents.

Manual-Based Personalized Intervention for Mothers of Children With SLD/ADHD: Effects on Maternal and Family Resources and Children's Internalizing/Externalizing Behaviors

Objective: This study explored manual-based personalized intervention for mothers of children with SLD and/or ADHD, as possibly contributing to (a) mothers' parenting-related emotional/coping resources, (b) family functioning, and (c) child adjustment, compared with a control group of mothers. Method: Participants were 73 mothers of a child formally diagnosed with SLD and/or ADHD ages 7-17. Mothers were assigned to an experimental (n=40) or control (n=33) group. Short-term intervention utilized a three-stage emotion-cognition-behavior model. Pre-post assessments included maternal affective resources (positive/negative affect, parenting stress), maternal coping resources (general coping strategies, coping specifically with diagnosed child's negative emotions), family cohesion/adaptability, and diagnosed child's externalizing/internalizing syndromes. Results: Significant interactions emerged between group (experimental/control) and time (pre/post) for most study variables. Conclusion: Findings clearly revealed the intervention's significant impact. Only the trained mothers demonstrated significant gains over time for most of the maternal, family, and child indices, whereas the untrained mothers did not.

Group Intervention with Aggressive Children and Youth Through Bibliotherapy

Aggression in the school is one of the most disturbing behaviors that teachers and students face. It is usually addressed through preventive treatments, leaving the highly aggressive students unaffected. Group psychotherapy is a viable method to treat aggressive youth, despite reservations raised in the professional literature, when therapy is adjusted to this unique population. Aggressive children and youth are quite resistant to change, thus, creative methods are needed to engage them in therapy. This article suggests an innovative intervention, using bibliotherapy as an adjunct to an integrative theory of treatment, adjusted to the specific characteristics of aggressive children. The article describes the intervention, its theoretical foundation, and provides wide evidence for its effectiveness with aggressive children and youth.

Efficacy of an individualized social competence training for children with Oppositional Defiant Disorders/Conduct Disorders

OBJECTIVES

Group-based Cognitive-Behavioral Therapy of children with aggressive behavior has resulted in significant reductions of behavior problems with small to medium effect sizes. We report the efficacy of an individualized Treatment Program for Children with Aggressive Behavior.

METHOD

A within-subject design with two phases (waiting, treatment) was chosen. Sixty boys aged 6-12 years with peer-related aggressive behavior were included. The course of the outcome measures (growth rates) during a 6-week waiting phase was compared with those in the subsequent treatment phase (24 weekly child sessions together with an average of 8 parent contacts) by multilevel modeling. Primary outcome was peer-related aggressive behavior rated by parents. Further outcome measures included parent ratings and patient self-reports of aggressive and prosocial behavior.

RESULTS

During the treatment, growth rates for all parent-rated outcome measures were significant (p < .001) and comparison with the waiting phase indicated a stronger decrease in aggressive behavior and a stronger increase in prosocial behavior. For all self-rated outcome measures, growth rates during the treatment were significant (p < .01), but comparison with the waiting phase indicated a stronger decrease only for disturbance of social interaction.

CONCLUSIONS

The treatment program is an effective intervention for children with peer-related aggressive behavior.

Psychosocial Interventions for Child Disruptive Behaviors: A Meta-analysis

BACKGROUND

Disruptive behavior disorders are among the most common child and adolescent psychiatric disorders and associated with significant impairment.

OBJECTIVE

Systematically review studies of psychosocial interventions for children with disruptive behavior disorders.

METHODS

We searched Medline (via PubMed), Embase, and PsycINFO. Two reviewers assessed studies against predetermined inclusion criteria. Data were extracted by 1 team member and reviewed by a second. We categorized interventions as having only a child component, only a parent component, or as multicomponent interventions.

RESULTS

Sixty-six studies were included. Twenty-eight met criteria for inclusion in our meta-analysis. The effect size for the multicomponent interventions and interventions with only a parent component had the same estimated value, with a median of -1.2 SD reduction in outcome score (95% credible interval, -1.6 to -0.9). The estimate for interventions with only a child component was -1.0 SD (95% credible interval, -1.6 to -0.4).

LIMITATIONS

Methodologic limitations of the available evidence (eg, inconsistent or incomplete outcome reporting, inadequate blinding or allocation concealment) may compromise the strength of the evidence. Population and intervention inclusion criteria and selected outcome measures eligible for inclusion in the meta-analysis may limit applicability of the results.

CONCLUSIONS

The 3 intervention categories were more effective than the control conditions. Interventions with a parent component, either alone or in combination with other components, were likely to have the largest effect. Although additional research is needed in the community setting, our findings suggest that the parent component is critical to successful intervention.

Children with and without learning disabilities: a comparison of processes and outcomes following group counseling

This study compared outcomes and processes in counseling groups of an expressive-supportive modality for children with learning disabilities (LD) and without them (NLD). Participants were 266 students (ages 10-18), all referred for emotional, social, and behavioral difficulties; of these, 123 were identified with LD and 143 were not. There were 40 groups in all--20 with LD children and 20 with NLD. Outcome variables included adjustment, social competence, and academic achievements. Process variables included bonding, group functioning, and client behavior. Analyses were nested using mixed models. Results indicated no differences in outcomes or process variables between populations except for academic achievements; some between-group differences were found in the effect of processes on outcomes. It was concluded that children with LD may be successfully treated in expressive-supportive counseling groups for their emotional and social difficulties.

School-based integrated and segregated interventions to reduce aggression

The goal of the study was to assess two types of school-based interventions--a class intervention (integrated) and a small group counseling (segregated) intervention for highly aggressive children--and to determine which is more efficacious in reducing individual and classroom aggression, lessening internalizing and externalizing behavior, and increasing positive classroom relationships. The study, conducted in Israel, included 904 children from 13 schools. In each school, one age level was selected and divided randomly into three experimental conditions: psychoeducational class intervention, small group counseling, and control. In all classrooms, the highly aggressive children were identified a priori (n=166). Analyses were conducted separately for the aggressive children and their nonaggressive classmates, in a nested procedure (mixed models). Results showed similar positive outcomes on all variables in both treatment groups, and higher compared with the control group. The discussion focuses on the strengths of each type of intervention.

A model parent group for enhancing aggressive children's social competence in Taiwan

This paper presents a semi-structured psychoeducational model of group work for parents of aggressive children based on concepts of co-parenting and bidirectionality. The group was developed for enhancing five Taiwanese aggressive children's social competence by promoting positive interactions within family. Topics covered in the group included identifying parenting styles, forming parental alliances, fostering parent-child mutual initiations/mutual compliances, establishing parent-child co-regulation, and responding to aggressive children's negative emotions. Pre- and post-group comparisons suggested the effectiveness of the group model.

The effect of affective bibliotherapy on clients' functioning in group therapy

Abstract The effect of affective group bibliotherapy (GB) was compared to affective group therapy (GT) on patients' functioning in therapy and their session impression. Three small groups totaling twenty-five in-patients in a hospital in Israel participated in the study. Clients concurrently participated in both group types, undergoing three sessions in each condition. In-therapy behaviors were assessed through the Client Behavior System (CBS; Hill & O'Brien, 1999). Results indicated that in the GB condition compared to the GT condition, clients showed less resistance, used simple responses less frequently, and expressed greater affective exploration. The Session Evaluation Questionnaire (SEQ; Stiles et al., 1994) was used to measure clients' impressions of the sessions. Results indicated that patients evaluated the two treatment conditions equally. Overall, the results support earlier findings, suggesting that affective bibliotherapy can be an effective method of treatment.