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

Abstract

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. The sample included 180 high-risk children (69% male) who received intervention in 30 separate Coping Power intervention groups (six children assigned per group). The evidence-based Coping Power prevention program consists of 32 sessions delivered during the 4th and 5th grade years; only the child component was used in this study. The behavioral coding system used in the analyses included two clusters of behaviors for children (positive; negative) and two for the primary group leaders (group management; clinical skills). Growth spline models suggest that high levels of children’s negative behaviors predicted increases in teacher and parent rated aggressive and conduct problem behaviors during the follow-up period in the three of the four models. Therapist use of clinical skills (e.g., warmth, nonreactive) predicted less increase in children’s teacher-rated conduct problems. These findings suggest the importance of clinical training in the effective delivery of evidence-based practices, particularly when working with high-risk youth in groups.

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Notes

  1. 1.

    In follow-up exploratory analyses of the two predictors of teacher-rated Conduct Problems, conducted because of potential colinearity due to significant correlations among predictors, three HLM analyses using on predictor were conducted. When only child negative behavior was used as a predictor, negative behavior significantly predicted the slope for Conduct Problems, T (118) = 2.68, p = 0.008. When only leaders’ Clinical Skills was as a predictor, Clinical Skills significantly predicted the slope for Conduct Problems, T (28) = −2.28, p = 0.03. When only leaders’ Group Management behaviors was a predictor, Group Management did not significantly predict the slope for Conduct Problems, T (28) = −0.54, p = 0.59. Thus, the pattern of predictors in single-predictor models for teacher-rated Conduct Problems exactly paralleled the results for the full model tested.

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Acknowledgments

This paper has been supported by grants from the National Institute of Drug Abuse (R01 DA023156) and the National Institute of Child Health & Human Development (R01 HD079273).

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Correspondence to John E. Lochman.

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Conflict of Interest

John Lochman is the co-developer of the Coping Power program, and he receives royalties from Oxford University Press for the implementation guides for this program.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Lochman, J.E., Dishion, T.J., Boxmeyer, C.L. et al. Variation in Response to Evidence-Based Group Preventive Intervention for Disruptive Behavior Problems: A View from 938 Coping Power Sessions. J Abnorm Child Psychol 45, 1271–1284 (2017). https://doi.org/10.1007/s10802-016-0252-7

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Keywords

  • Aggressive behavior
  • Group process
  • Clinical skills
  • Preventive intervention