Project Support
OVERVIEW
This intervention was designed to help women who were leaving a shelter for battered women and were in the process of setting up a home away from their batterer. The program was specifically focused towards women who had a child between the ages of 4 and 9 who had exhibited behaviors that fit the DSM-IV criteria for oppositional defiant disorder (ODD) or conduct disorder (CD). Thirty-six families were randomly assigned into either a control group or a treatment group. The treatment group took part in an intervention which attempted to provide emotional and instrumental support for the mothers, as well as teach them child management skills that would help decrease their child's conduct problems. Relative to the control group, mothers in the treatment group had greater improvements in child management skills, and their children's behavior improved at a faster rate and were within the normative range of conduct problems by the end of the study.
DESCRIPTION OF PROGRAM
Target population: Families with children who have displayed clinical levels of conduct problems, are making the transition out of shelters for battered women, and are in the process of setting up homes independent of their batterers.
The intervention consists of two main components: providing mothers with emotional and instrumental support as they make a transition out of a shelter for battered women and attempt to start up again away from their batterer and teaching them how to use effective child management skills, in an effort to reduce their child's conduct problems.
EVALUATION(S) OF PROGRAM
Jouriles, E. N., McDonald,
R., Spiller, L.,
Evaluated population: Of the 36 participating children, 26 were boys and 10 were girls. Twenty-six met the criteria for oppositional defiant disorder (ODD), and 10 met criteria for conduct disorder (CD). The mean age of the children was 5.7 years, while the mean age of the mothers was 28 years. The mothers also had a mean of 11 years of education. There were 11 African American mothers, 10 Caucasian, 12 Latino, 1 Asian American, and 2 who classified themselves as Other. The mean number of acts of violence experienced by the woman (from their partner) during the last year was 68.4. Seventy-five percent of the mothers reported that they had been beaten up by their partner, while 36% reported that their partner had used or threatened to use a knife or gun against them in the year before their shelter residence. All families were low-income.
Approach: Families expressing interest were given a screening appointment as long as they met the preliminary requirements: Have a child between 4 and 9 years of age, and be able to communicate in English. At the screening appointment set up to determine the family' eligibility for the study, the following requirements had to be met: Report at least one physically violent act by a male partner in the last 12 months, and have at least one child between the ages of 4 and 9 who met the DSM-IV criteria for oppositional defiant disorder (ODD) or conduct disorder (CD). If more than one child met the criteria, the youngest child in the family to meet the requirements was selected as the target child. Families with serious mental illness were not allowed to participate in the study, but were offered clinical referrals as appropriate. Families eligible during this in-shelter screening appointment were followed after leaving the shelter to determine eligibility at that point. In order to continue eligibility upon leaving the shelter, families had to meet the following requirements: The mother and the target child must be living together in the same household, the former partner must not be residing in the household, the household had to be within 50 miles of the shelter, and the residence had to be safe enough for the project staff to visit regularly.
Of the 153 families who were initially screened, 73 met the preliminary requirements during the in-shelter screening, and 40 continued to be eligible to participate in the study after departure from the shelter. Of these 40 families, 4 served as participants during the pilot stage of the study, and the remaining 36 composed the final sample.
Families had an initial in-home assessment conducted shortly after the family settled into their new residence. After this, they were randomly assigned to either the control or intervention condition; each group was made up of 13 families with a child who exhibited behavior consistent with an ODD diagnosis, and 5 families with a child who exhibited behavior consisted with a CD diagnosis. Assessments typically lasted 2-3 hours and were repeated every 4 months, for a total of 5 assessments over a 16-month period. They consisted of questionnaires for mothers and a 45-minute videotaped family interaction. Thirty-one of the families were able to complete all five assessments.
The intervention group participated in weekly in-home sessions for up to 8 months after shelter departure. The sessions were 1-1.5 hours in length and were led by a team of trained therapists and advanced students. There was flexibility in terms of the frequency of the sessions, with some families not being able to make it to a session every single week, and other families receiving more than one session a week - especially during times of crisis. On average, families participated in 23 sessions over this period of time. The intervention was made up of two primary components. The first was providing families with social and instrumental support and mothers with problem solving skills. Mothers received emotional support during their transition out of the shelter and received help with physical resources and social supports that promoted their effort to become self-supporting. They also addressed safety concerns and received training on decision making and problem-solving skills. The second component focused on teaching mothers skills that would increase desirable child behavior, decrease undesirable child behavior, help them communicate more effectively and develop a more warm and positive relationship with their children. The control group participants were contacted monthly but received no services from the team. They were instead encouraged to make use of the services already provided in their community when necessary. They also received referrals to services, when appropriate.
Measures used to assess treatment effects included the Child Behavior Checklist (CBCL), which is a widely used measure of both externalizing and internalizing problems. Mothers were also observed during 45-minute sessions with their children, and later coded on their child management skills. This looked at the extent to which mothers correctly used specific skills and if they interacted with their children in an involved, affectionate and responsive manner. The Symptom Checklist-90 Revised (SCL-90-R) was also used, as an index of mother's psychological distress.
Results: Researchers found that externalizing problems improved over time for both groups, but they improved at a faster rate among children who were part of the intervention, than among the children in the control group. Children's internalizing problems also decreased over time; however, group differences were not statistically significant. Mothers in the treatment group had significantly higher levels of child management skills than mothers in the control group, and these management skills also improved more rapidly in the treatment group. Mothers' level of psychological distress diminished over time; however, no significant differences were found across groups. Finally, researchers found that the level of externalizing problems for the treatment group was within the normative range by the end of the study, while the level of externalizing problems for the children in the control group remained above the normative range.
SOURCES FOR MORE INFORMATION
References
Jouriles, E. N., McDonald, R.,
Spiller, L.,
Program categorized in this guide according to the following:
Evaluated participant ages: 0-5, 6-11
Program components: counseling/therapy; home visiting; parent or family component
Measured outcomes: social and emotional health and development; behavioral problems;
KEYWORDS: Early Childhood (0-5), Children (3-11), Middle Childhood (6-11), Counseling/therapy, Home Visitation, Home-based, Social/Emotional Health, Behavioral Problems, Oppositional Defiant Order, Conduct Disorder, Externalizing Problems, Parent Management Skills, High-Risk, Skills Training, Family Therapy, African American or Black, White or Caucasian, Latino or Hispanic, Asian, Family Conflict, Problem-Solving Skills, Mental Health
Program information last updated 9/12/08.
|
|
|
© Child Trends 2003 |
|
|
|
