Program

Sep 22, 2006

OVERVIEW

The Cognitive Behavioral Family Intervention (CBFI) is designed
to reduce maternal depression as well as children’s disruptive behavior through
integrating cognitive therapy strategies to treat depression and teach
parenting skills. Families in CBFI receive clinical and home visits that
include therapist-guided practice, role-play, feedback, and coaching to teach
behavioral principles and techniques to reduce depression and increase
parenting skills. Mothers were taught cognitive behavior management strategies
such as identifying and interrupting dysfunctional child-related cognitions.
Families were randomly assigned to contrasting treatments, in order to compare
Behavioral Family Intervention (BFI) to Cognitive Behavioral Family
Intervention. Thus, there is no non-treatment control group. The researchers
found that both interventions reduced maternal depression and child disruptive
behavior in the short term; however, the impact on clinically significant
Maternal depression at the 6-month follow-up was longer for CBFI.

DESCRIPTION OF PROGRAM

Target population: Families with a
clinically depressed parent and a child with significant conduct problems.

The
Cognitive Behavioral Family Intervention (CBFI) is designed to reduce mother’s
depression and children’s disruptive behavior through integrating cognitive
therapy strategies to treat depression and teach parenting skills. Therapy
consists of 12 sessions, including 8 clinic sessions and 4 feedback sessions in
the mother’s homes. These sessions are completed over a 3-5 month period.
During the sessions, parents gain knowledge of positive parenting
techniques. Parents learn to reach agreement about appropriate and
inappropriate behaviors and how to address them, including proper
punishments. Other techniques regarding positive parenting include
praising children, attention, and positive reinforcement. In the CBFI
sessions, the treatment of the mother’s depression is integrated with parent
training. The mothers are taught relaxation techniques such as deep
breathing and other coping techniques to help them deal with their depression
and how it relates to their children. Parenting sessions address positive
approaches such as contingent praise and attention and strategies for dealing
with misbehavior.

EVALUATION(S) OF PROGRAM

Evaluated population: Subjects included 47
families with mothers who were classified as depressed and at least one child
who was classified as having a behavioral problem according to commonly used
criteria found in the Diagnostic and Statistical Manual, Fourth Edition
(DSM-IV). The children were 3 to 9 years of age and showed no evidence of
developmental disabilities. The families were randomly assigned to either the
BFI group or the CBFI group. Thirty-seven families completed treatment and the
6-month follow-up.

Approach: The researchers collected data using home videotaping and 20-minute
observation sessions. These observations were coded using the Family
Observation Schedule. The Child Behavior Checklist and Parent Daily Report were
also used to measure treatment outcomes. Observers included two postgraduate
research assistants. Further treatment measures included the Beck Depression
Inventory, the Automatic Thoughts Questionnaire, and the Parent Sense of
Competence Scale.

Results: Both the BFI and CBFI interventions were effective in reducing children’s
disruptive behavior (F= 37.81 p≤0.0001 for the Child Behavior
Checklist). Mother’s weekly rating of child behavior also showed a
reduction in disruptive actions. This was measured through observation by
the therapist and self-report measures from the family at post
intervention. However, there was no reliable difference in reduction of
the child’s behavior between the CBFI and the BFI methods.

Researchers
concluded that the study was limited by the fact that they were unable to
conduct clinical diagnostic interviews at follow-up. Researchers were also
unable to conduct formal reliability checks of protocol adherence. Threats to
internal validity can not be ruled out. Furthermore, the possibility that
improvements in child and parent functioning were due to maturation can not be
ruled out.

SOURCES FOR MORE INFORMATION

References

Sanders,
M. R. & McFarland, M. (2000). Treatment of depressed mother with disruptive
children: A controlled evaluation of cognitive behavioral family intervention. Behavior
Therapy, 31
, 89-112.

KEYWORDS: Social/Emotional
Health and Development, Behavioral Problems, Counseling/Therapy, Life Skills
Training, Parent Training/Education, Home Visitation, Cognitive Development, Disruptive Behavior
Disorders, Early Childhood (0-5), Middle Childhood (6-11), Children, Depression,
Co-ed

Program
information last updated 09/22/06.