Program

Jun 21, 2012

OVERVIEW

The
Utrecht Coping Power Program is a clinic-based adaptation of the Coping Power
Program that aims to reduce problem behaviors and promote pro-social behaviors
in children with disruptive behavior disorders. This program was found to have
positive impacts on overt aggression and long-term substance use, but otherwise
does not have significantly better outcomes than care as usual. A five-year
follow-up study found that those in the Utrecht Coping Power Program were less
likely to smoke and drink than those in the control group; but no differences in
delinquency were found.

DESCRIPTION OF PROGRAM

Target Population:
Clinically
referred school-aged children with disruptive behavior disorders.

The
Utrecht Coping Power Program is a manualized clinic-based intervention designed
to decrease disruptive behaviors and increase prosocial behaviors in a cost
effective way. This program was adapted from the

Coping Power Program
, a school-based prevention program for at-risk
children, to fit an outpatient clinic context and population. Both parents and
children participate in this intervention over the course of 9 months. Children
attend 23 group sessions that focus on basic communication skills, recognition
of emotions, appropriate ways of handling anger, and reflective problem-solving
skills. Parents attend 15 parent group sessions focused on managing their
child’s problem behavior, praising good behavior, family problem solving, and
building family cohesion. The parent and child components of this intervention
are integrated, in that the same therapist runs both groups and there is
significant overlap in the topics covered.

According
to Van de Wiel and colleagues (2003), the cost of UCPP treatment for one family
is $334. A cost effectiveness analysis revealed that UCPP was 49 percent
cheaper than care as usual in attaining the same outcomes.

EVALUATION
OF PROGRAM

Study 1: Van de Wiel, N. (2002).The effect
of manualized behavior therapy with disruptive behavior disordered children in
everyday clinical practice: A randomized clinical trial.

(Unpublished doctoral dissertation). University Medical Center, Utrecht, The
Netherlands.

Evaluated
Population:

The sample
included a total of 77 children who were referred to outpatient clinics in
Utrecht, The Netherlands, for treatment of disruptive behaviors. To be included
in the study, children had to have an IQ ≥ 80, be 8 to 13 years old, be living
within a family, and meet criteria for a diagnosis of a disruptive behavior
disorder (i.e., Oppositional Defiant Disorder or Conduct Disorder). The average
age of the sample was 10.1 years old, the sample was 88 percent male, and the
entire sample was Caucasian/White.

Approach: Eligible
children were individually randomized to receive the UCPP intervention (n=38) or
care as usual (n=39). Those in the care as usual condition were provided with
typical services offered at the outpatient clinics. Parent-reported and
teacher-reported problem behaviors and pro-social competence were measured prior
to treatment, at the end of treatment, and 6 months after the end of treatment.
There were no significant demographic, behavioral, or diagnostic differences
between the two groups at the start of treatment.

Results: Children in both conditions showed improvement in reduction of problem
behaviors and increase in pro-social behaviors at post-treatment and follow-up.
The only outcome on which the UCPP had a significantly greater impact than care
as usual was parent-reported overt aggressive behavior.

Study 2:
Van de Wiel, N. M. H., Matthys, W., Cohen-Kettenis, P. T., Maassen, G. H.,
Lochman, J. E., & Van Engeland, H. (2007). The effectiveness of an experimental
treatment when compared to care as usual depends on the type of care as usual.
Behavior Modification, 31,298-312. doi:10.1177/0145445506292855

Evaluated
Population:

See Study
1 (above).

Approach:
This study
examined the effectiveness of UCPP compared to specific types of care as usual.
The researchers coded the services received in the care as usual group as family
therapy (n=10), behavior therapy (n=16), and various other treatments (n=13).

Results: As reported by parents, the UCPP intervention had a greater impact on overt
aggression than family therapy. This difference was not present when comparing
UCPP to behavior therapy, indicating that the comparison of this experimental
treatment to usual care depends on the type of usual care.

Study 3:
Zonnevylle-Bender, M. J. S., Matthys, W., Van de Wiel, N. M. H., & Lochman, J.
E. (2007). Preventive effects of treatment of disruptive behavior disorder in
middle childhood on substance use and delinquent behavior. Journal of the
American Academy of Child & Adolescent Psychiatry, 46,
33-39.
doi:10.1097/01.chi.0000246051.53297.57

Evaluated
Population:

See Study
1 (above).

Approach: This
study examined the long-term preventive effects of the UCPP intervention. Five
years after the start of treatment, self-reported substance use and delinquent
behavior were measured. Sixty-one of the original 77 participants (79 percent)
were located and agreed to participate in this follow-up.

Results: On measures of past month cigarette smoking and lifetime marijuana use,
participants who received the UCPP intervention used significantly less than
those who received usual care. No significant impacts were found for delinquent
behavior.

SOURCES
FOR MORE INFORMATION

References

Van de
Wiel, N. (2002). The effect of manualized behavior therapy with disruptive
behavior disordered children in everyday clinical practice: A randomized
clinical trial.
(Unpublished doctoral dissertation). University Medical
Center, Utrecht, The Netherlands.

Van de
Wiel, N. M. H., Matthys, W., Cohen-Kettenis, P., & Van Engeland, H. (2003).
Application of the Utrecht coping power program and care as usual to children
with disruptive behavior disorders in outpatient clinics: A comparative study of
cost and course of treatment. Behavior Therapy, 34,421-436.
doi:10.1016/S0005-7894(03)80028-X

Van de
Wiel, N. M. H., Matthys, W., Cohen-Kettenis, P. T., Maassen, G. H., Lochman, J.
E., & Van Engeland, H. (2007). The effectiveness of an experimental treatment
when compared to care as usual depends on the type of care as usual. Behavior
Modification, 31,
298-312. doi:10.1177/0145445506292855

Zonnevylle-Bender, M. J. S., Matthys, W., Van de Wiel, N. M. H., & Lochman, J.
E. (2007). Preventive effects of treatment of disruptive behavior disorder in
middle childhood on substance use and delinquent behavior. Journal of the
American Academy of Child & Adolescent Psychiatry, 46,
33-39.
doi:10.1097/01.chi.0000246051.53297.57

Contact
Information:

Walter
Matthys, M.D., Ph.D.

Rudolf
Magnus Institute of Neuroscience

Department
of Child & Adolescent Psychiatry

B01.324
University Medical Center Utrecht

P.O. Box
85500

3508 GA
Utrecht, The Netherlands

Email:
w.matthys@umutrecht.nl

KEYWORDS:
Children
(3-11), Adolescents (12-17), Males and Females (Co-ed), White/Caucasian,
Clinic/Provider-based, Manual, Cost, Counseling /Therapy, Parent or Family
Component, Parent Training/Education, Skills Training, Conduct/Disruptive
Disorders, Delinquency, Tobacco Use, Marijuana/Illicit/Prescription Drugs,
Alcohol Use

Program
information last updated on 6/21/12.

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