Conduct problem children are frequently encountered by nurses caring for pediatric populations. Without intervention, such children have a poor prognosis with high rates of crime, drug abuse and school dropout. The optimal therapy remains unclear. Additionally, the cost of most therapies severely limits their availability to parents in need. The long-term objective of this program is to develop cost-effective and widely applicable programs of proven effectiveness to treat families with conduct problem children. Our prior studies have documented that videotape modeling treatment for parents is highly effective in improving both parent and child behaviors. The current program will assess the long-term durability of such therapies as well as evaluate two new treatment designed to improve long-term outcomes. The endpoints for all three studies will be direct observations of parent-child interaction and multiple questionnaires by parents and teachers. The first study (LONG-TERM FOLLOWUP) will conduct detailed 2-year followup of 114 families with conduct problem children who were previously randomly assigned to one of three treatments: 1) group therapy, 2) self-administered videotape therapy, or 3) videotape-based group therapy (VTG).
The specific aims are to determine which treatment is the most effective and to determine the salient predictors of long-term success or relapse. The second study (ENHANCE THERAPY) will randomize 60 families to either standard VTG plus 1 year (12 sessions) of ENHANCE therapy or to VTG without ENHANCE. The new videotape ENHANCE therapy is aimed at correcting factors that have predicted treatment failure in prior studies and is primarily directed at parental problems. Posttreatment followup will be to 2 years.
The specific aims are to determine whether ENHANCE improves parent functioning, reduces relapse and improves long-term outcomes. The third study (KIDVID) will randomize 63 families to three conditions; 1) a waiting-list control group, 2) our standard training for parents (VTG), or 3) VTG for parents plus a newly developed videotape child-training program (KIDVID).
The specific aim i s to determine whether treating the whole family system (parent and child) improves outcomes. The format of all of the programs (videotape nurse-led group discussion) is capable of significantly expanding the ability of nurses to care for the increasing numbers of families with, and at risk for, conduct problem children.
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