Intervention format and therapist-child agreement associated with therapeutic alliance and outcomes.

Objective: The study examined the effects of therapeutic alliance (TA; relational bond, task collaboration) on externalizing behavior outcomes, how TA can operate differently when children are seen in individual versus group sessions, and how therapist-child disagreement in perceptions of TA affects outcomes.

Method: Three hundred sixty children (Ages 9.2-11.

Mindful Coping Power Effects on Children's Autonomic Nervous System Functioning and Long-Term Behavioral Outcomes.

Mindful Coping Power (MCP) was developed to enhance the effects of the Coping Power (CP) preventive intervention on children's reactive aggression by integrating mindfulness training into CP. In prior pre-post analyses in a randomized trial of 102 children, MCP improved children's self-reported anger modulation, self-regulation, and embodied awareness relative to CP but had fewer comparative effects on parent- and teacher-reported observable behavioral outcomes, including reactive aggression. It was hypothesized that MCP-produced improvements in children's internal awareness and self-regulation, if maintained or strengthened over time with ongoing mindfulness practice, would yield improvements in children's observable prosocial and reactive aggressive behavior at later time points.

Mindful Coping Power: Comparative Effects on Children's Reactive Aggression and Self-Regulation.

Coping Power (CP) is an evidence-based preventive intervention for youth with disruptive behavior problems. This study examined whether Mindful Coping Power (MCP), a novel adaptation which integrates mindfulness into CP, enhances program effects on children's reactive aggression and self-regulation. A pilot randomized design was utilized to estimate the effect sizes for MCP versus CP in a sample of 102 child participants (fifth grade students, predominantly low-middle income, 87% Black).

Substance Use Outcomes from Two Formats of a Cognitive-Behavioral Intervention for Aggressive Children: Moderating Roles of Inhibitory Control and Intervention Engagement.

Although cognitive-behavioral interventions have reduced the risk of substance use, little is known about moderating factors in children with disruptive behaviors. This study examined whether aggressive preadolescents' inhibitory control and intervention engagement moderates the effect of group versus individual delivery on their substance use. Following screening for aggression in 4th grade, 360 children were randomly assigned to receive the Coping Power intervention in either group or individual formats.

Effects of Autonomic Nervous System Functioning and Tornado Exposure on Long-Term Outcomes of Aggressive Children.

This study examined whether pre-disaster indicators of sympathetic and parasympathetic activity moderated the relation between degree of disaster exposure from an EF-4 tornado and changes in the externalizing and internalizing behavior problems of children at-risk for aggression. Participants included 188 children in 4th-6th grades (65% male; 78% African American; ages 9-13) and their parents from predominantly low-income households who were participating in a prevention study when the tornado occurred in 2011. Fourth-grade children who exhibited elevated levels of aggressive behavior were recruited in three annual cohorts.

Group versus individual format of intervention for aggressive children: Moderators and predictors of outcomes through 4 years after intervention.

This study originated in collaboration with Thomas Dishion because of concerns that a group format for aggressive children might dampen the effects of cognitive-behavioral intervention. Three hundred sixty aggressive preadolescent children were screened through teacher and parent ratings. Schools were randomized to receive either an individual or a group format of the child component of the same evidence-based program.

Cognitive Behavioral Intervention for Youth at Risk for Conduct Problems: Future Directions.

This article briefly overviews the history of cognitive behavioral intervention (CBI) for children displaying early signs, or actual diagnoses, of conduct disorders. A series of randomized control trials have identified evidence-based CBI programs for children with these behavior problems at various developmental stages from preschool through adolescence. Although it is critically important for the field to disseminate these existing programs as developed, we argue that it is important to also move beyond the existing evidence-based programs.

The Influence of Treatment Engagement on Positive Outcomes in the Context of a School-Based Intervention for Students with Externalizing Behavior Problems.

We examined the stability of and cross-influences between externalizing behaviors and intervention engagement among children participating in a randomized clinical trial of an intervention for disruptive behavioral youth. Analyses also accounted for the influence of caregiver depression, family relationship quality, and sociodemographic factors (race, income) on the relationship between behaviors and intervention engagement. Analyses were based on 118 children participating in the Coping Power intervention.

Testing the feasibility of a briefer school-based preventive intervention with aggressive children: A hybrid intervention with face-to-face and internet components.

This study describes the results from a feasibility study of an innovative indicated prevention intervention with hybrid face-to-face and web-based components for preadolescent youth. This intervention includes a considerably briefer set of face-to-face sessions from the evidence-based Coping Power program and a carefully integrated internet component with practice and teaching activities and cartoon videos for children and for parents. The Coping Power - Internet Enhanced (CP-IE) program introduces a set of cognitive-behavioral skills in 12 small group sessions for children delivered during the school day and 7 group sessions for parents.

Variation in Response to Evidence-Based Group Preventive Intervention for Disruptive Behavior Problems: A View from 938 Coping Power Sessions.

Prior research suggests that under some conditions, interventions that aggregate high-risk youth may be less effective, or at worse, iatrogenic. However, group formats have considerable practical utility for delivery of preventive interventions, and thus it is crucial to understand child and therapist factors that predict which aggressive children can profit from group intervention and which do not. To address these questions we video-recorded group Coping Power intervention sessions (938 sessions), coded both leader and participant behavior, and analyzed both leader and children's behaviors in the sessions that predicted changes in teacher and parent, reports of problem behavior at 1-year follow up.

Pre-Post Tornado Effects on Aggressive Children's Psychological and Behavioral Adjustment Through One-Year Postdisaster.

Using a risk-resilience framework, this study examined how varying levels of exposure to a natural disaster (EF-4 tornado) and children's characteristics (sex; anxiety) influenced the behavioral and psychological adjustment of children who shared a common risk factor predisaster (elevated aggression) prior to exposure through 1-year postdisaster. Participants included 360 children in Grades 4-6 (65% male; 78% African American) and their parents from predominantly low-income households who were already participating in a longitudinal study of indicated prevention effects for externalizing outcomes when the tornado occurred in 2011. Fourth-grade children who were screened for overt aggressive behavior were recruited in 3 annual cohorts (120 per year, beginning in 2009).

Evidence-based preventive intervention for preadolescent aggressive children: One-year outcomes following randomization to group versus individual delivery.

Objective: Some research suggests that group interventions with antisocial youth may, on occasion, have iatrogenic effects. This is the first study to test the effects of group versus individual delivery of evidence-based intervention for aggressive children.

Method: Three hundred sixty fourth-grade children were randomly assigned by school to group coping power (GCP) or individual coping power (ICP).

Counselor-Level Predictors of Sustained Use of an Indicated Preventive Intervention for Aggressive Children.

Despite widespread concern about the frequent failure of trained prevention staff to continue to use evidence-based programs following periods of intensive training, little research has addressed the characteristics and experiences of counselors that might predict their sustained use of a program. The current study follows a sample of school counselors who were trained to use an indicated preventive intervention, the Coping Power program, in an earlier dissemination study, and determines their levels of continued use of the program's child and parent components in the 2 years following the counselors' intensive training in the program. Counselor characteristics and experiences were also examined as predictors of their sustained use of the program components.

Integrating the Family Check-Up and the parent Coping Power program.

Engaging families in school-based preventive interventions for aggressive youth can be especially challenging. The current article describes an integration of a parent engagement model, called the Family Check-Up, with an evidence-based intervention for youth with aggressive behaviours called Coping Power. The overall goal of the integration was to increase parental involvement and exposure to the core elements of the Coping Power programme to optimize impact on families and their children.

Predictors of engagement in a school-based family preventive intervention for youth experiencing behavioral difficulties.

The researchers longitudinally assessed parent and child levels of engagement in an evidence-based preventive intervention for children. The sample included 114 fifth graders with aggressive, disruptive behaviors and their parents who participated in the Coping Power Program. Findings indicate that levels of engagement differentially fluctuated for children and parents throughout the course of the intervention.

Does a booster intervention augment the preventive effects of an abbreviated version of the coping power program for aggressive children?

Booster interventions have been presumed to be important methods for maintaining the effects of evidence-based programs for children with behavioral problems, but there has been remarkably little empirical attention to this assumption. The present study examines the effect of a child-oriented booster preventive intervention with children who had previously received an abbreviated version (24 child sessions, 10 parent sessions) of the Coping Power targeted prevention program. Two hundred and forty-one children (152 boys, 89 girls) were screened as having moderate to high levels of aggressive behavior in 4th grade, then half were randomly assigned to receive the abbreviated Coping Power program in 5th grade, and half of the preventive intervention children were then randomly assigned to a Booster condition in 6th grade.

Cognitive-behavioral therapy for externalizing disorders in children and adolescents.

This article focuses on the use of cognitive-behavioral therapy (CBT) strategies for children and adolescents with externalizing disorders. Following a description of risk factors for youth antisocial behavior, several components common to CBT interventions for youth with externalizing behaviors will be described. Using the Coping Power Program as a model, child treatment components including Emotion Awareness, Perspective Taking, Anger Management, Social Problem Solving, and Goal Setting will be reviewed.

The prevention of conduct problems.

This article summarizes the current knowledge base in the prevention of childhood conduct problems. First, childhood conduct problems and comorbid conditions are described, followed by a review of risk factors that have been found to contribute to the development of conduct problems. Risk factors include both internal child characteristics such as temperament and genetic/neurobiological influences, and external factors such as family, peer, and neighborhood influences.

Determinates of youth and parent satisfaction in usual care psychotherapy.

Objective: Client satisfaction with mental health services is used commonly as an indicator of the quality of care, but there is minimal research on the construct of client satisfaction in youth services, and the extent to which satisfaction is related to improvements in clinical functioning versus other determinants. We examined the relationship between parent and youth satisfaction with youth services, and tested for significant determinants of satisfaction across three major domains: (1) change in youth clinical functioning; (2) youth/family service entry characteristics; (3) treatment/therapist characteristics.

Method: The participants were 143 youths receiving community-based outpatient care.