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Skill Acquisition and Utilization During Evidence-Based Psychosocial Treatments for Childhood Disruptive Behavior Problems: A Review and Meta-analysis

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Abstract

We review 85 empirical articles published since 2000 that measured the acquisition and/or utilization of parent management skills and/or child cognitive-behavioral skills in the context of an evidence-based treatment (EBT) for childhood behavior problems. Results showed that: (1) there are no standardized measures of skill acquisition or skill utilization that are used across treatments, (2) little is known about predictors, correlates, or outcomes associated with skill acquisition and utilization, and (3) few studies systematically examined techniques to enhance the acquisition and utilization of specific skills. Meta-analytic results from a subset of 68 articles (59 studies) showed an overall treatment–control ES = .31, p < .01 for skill acquisition and ES = .20, p = ns for skill utilization. We recommend that future research focus on the following three areas: (1) development of standardized measures of skill acquisition and utilization from a “common elements” perspective that can used across EBTs; (2) assessment of the predictors, correlates, and outcomes associated with skill acquisition and utilization; and (3) development of innovative interventions to enhance the acquisition and utilization of cognitive-behavioral and parent management skills.

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Author information

Authors and Affiliations

  1. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Oliver Lindhiem, Amy D. Herschell & David J. Kolko

  2. University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Janelle Higa

  3. Wayne State University, Detroit, MI, USA

    Christopher J. Trentacosta

Authors
  1. Oliver Lindhiem
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  2. Janelle Higa
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  3. Christopher J. Trentacosta
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  4. Amy D. Herschell
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  5. David J. Kolko
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Corresponding author

Correspondence to Oliver Lindhiem.

Appendices

Appendix 1

Study-Level Codes

Bibliographic Reference (APA)

  1. 1.

    Study ID #. Assign a unique identification # to each study. Formatted as TX# (PCI 01, PCI 02, IYR 01, IYR 02, etc.)

    BPT:

    Behavioral parent training

    FTR:

    Fast Track

    IYR:

    Incredible years

    KEE:

    KEEP

    PCI:

    PCIT

    PMT:

    PMT/PMTO

    PPP:

    Triple P

    OTH:

    Other (includes BCBS, BMFC, BST, Making choices, Positive parenting, RIPP, Social skills training, TEAM, and Walker social skills)

  2. 2.

    Paper #. Assign each manuscript a unique #. Number in order from 1 to 85.

  3. 3.

    Publication year (last two digits).

Sample Descriptors

  1. 4.

    Mean age of sample at the beginning of the intervention (missing = 999).

  2. 5.

    Description of sample (eligibility criteria, severity of symptoms, etc.):

Research Design Descriptors

  1. 6.

    Method of assignment to conditions (random, non-random).

    1:

    random

    2:

    non-random

    9:

    cannot tell

    0:

    no control group

  2. 7.

    Total sample size (start of study)

  3. 8.

    Treatment group sample size (start of study)

  4. 9.

    Control group sample size (start of study; no control = 0)

Nature of the Treatment Descriptors

  1. 10.

    Intervention name

    1. 1

      Behavioral parent training

    2. 2

      Fast Track

    3. 3

      Incredible years

    4. 4

      KEEP

    5. 5

      PCIT

    6. 6

      PMT/PMTO

    7. 7

      Triple P

    8. 8

      Other (Definition: includes BCBS, BMFC, BST, Making choices, Positive parenting, RIPP, Social skills training, TEAM, and Walker social skills)

  2. 11.

    Intervention type

    1. 1

      treatment

    2. 2

      prevention

  3. 12.

    Intervention target

    1. 1

      parent

    2. 2

      child

  4. 13.

    Avg # of sessions for treatment group (missing = 999)

  5. 14.

    Nature of control group

    1. 1

      receives nothing (Definition: no evidence of any treatment)

    2. 2

      wait list (Definition: delayed treatment control, etc.)

    3. 3

      treatment as usual (Definition: control receives the usual treatment for DBD without special enhancement that constitutes the treatment of interest)

    4. 4

      alternative treatment (Definition: control is not really a control but another treatment [other than usual treatment] being compared with the focal treatment)

      9:

      cannot tell

      0:

      no control group

Appendix 2

Effect Size Level Codes

  1. 1.

    Study ID #

  2. 2.

    Paper #

  3. 3.

    Effect size #. Assign each effect size within a study a unique #. Number multiple effect sizes within a study sequentially (e.g., 1, 2, 3, 4…)

Dependent Measure Descriptors

  1. 4.

    Type of skill-use

    1:

    acquisition

    2:

    utilization

  2. 5.

    Parent or child skill

    1. 1

      parent skill

    2. 2

      child skill

  3. 6.

    Description of skill:

  4. 7.

    Category of skill:

    1. 1

      Positive parenting (Definition: study measure is a composite of multiple positive parenting behaviors, such as praise, positive affect, encouragement, positive reflections/descriptions of child behavior, and problem-solving)

    2. 2

      Negative parenting (Definition: study measure is a composite of multiple negative parenting behaviors, such as criticism, negative physical contact, vague instructions, vague commands, and interruptions)

    3. 3

      Parent praise (Definition: measures verbal and nonverbal affirmation of child)

    4. 4

      Parent verbal/nonverbal communication (Definition: measures increase in positive or decrease in negative verbalizations, social attention, or physical touch)

    5. 5

      Parent positive/negative consequences (Definition: measures effective use of consequences)

    6. 6

      Parent other (Definition: includes measures of monitoring, balance of turns, problem-solving, and broad treatment skills that are not clearly described)

    7. 7

      Child emotion labeling (Definition: measures identification of positive or negative feelings)

    8. 8

      Child problem-solving (Definition: measures positive strategies to address social problems)

    9. 9

      Child anger management (Definition: measures strategies for controlling anger such as relaxation techniques)

    10. 10

      Child social skills (Definition: measures understanding of social cues or appropriate engagement with peers)

    11. 11

      Child other (Definition: includes measures of broad treatment skills that are not clearly described)

  5. 8.

    Statistical nature of skill

    1:

    continuous

    2:

    dichotomous

    3:

    artificial dichotomous

    4:

    ordinal

  6. 9.

    Skill compared to treatment outcome (e.g., child externalizing behavior)?

    1:

    yes

    0:

    no

  7. 10.

    Effect size type

    1:

    pre–post

    2:

    treatment–control (at post)

Effect Size Data

  1. 11.

    Type of data effect size based on

    1:

    means and SDs

    2:

    t value or F value

    3:

    Chi-square (df = 1)

    4:

    frequencies or proportions

  2. 12.

    Page number where data found

  3. 13.

    Pre–post score correlation Only needed if effect size type is “pre–post” (i.e., #9 is coded as 1). If not needed (i.e., #9 is coded as 2), enter 999

When means and standards deviations are reported or can be estimated (**NOTE: for pre–post effect size comparisons, report post-data where it says “treatment group” and pre-data where it says “control group”):

14a.:

Treatment group sample size (or post-sample size; NA = 999)

14b.:

Control group sample size (or pre-sample size; NA = 999)

15a.:

Treatment group mean (or post-mean; NA = 999)

15b.:

Control group mean (or pre-mean; NA = 999)

16a.:

Treatment group SD (or post-SD; NA = 999)

16b.:

Control group SD (or pre-SD; NA = 999)

When proportions or frequencies are reported or can be estimated (**NOTE: for pre–post effect size comparisons, report post-data where it says “treatment group” and pre-data where it says “control group”):

17a:

n of treatment group with a successful outcome (or n at post; NA = 999)

17b.:

n of control group with a successful outcome (or n at pre; NA = 999)

18a.:

Proportion of treatment group with a successful outcome (or proportion at post; NA = 999)

18b.:

Proportion of control group with a successful outcome (or proportion at pre; NA = 999)

When significance test information is reported:

19a.:

t value (NA = 999)

19b.:

F value (NA = 999)

19c.:

Chi-square value (NA = 999)

Calculated Effect Size

20:

Effect size (NA = 999)

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Lindhiem, O., Higa, J., Trentacosta, C.J. et al. Skill Acquisition and Utilization During Evidence-Based Psychosocial Treatments for Childhood Disruptive Behavior Problems: A Review and Meta-analysis. Clin Child Fam Psychol Rev 17, 41–66 (2014). https://doi.org/10.1007/s10567-013-0136-0

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