An open trial of Collaborative Problem Solving in a naturalistic outpatient setting

Abstract

Collaborative Problem Solving (CPS) is an intervention for reducing children’s challenging behaviors. The aim of the present study was to evaluate the effects of family therapy using CPS in an outpatient clinic that specializes in treating children with challenging behaviors. One hundred and twenty families presented for treatment. Diagnoses at intake were varied, and 100 children (83%) had symptoms that were in the clinical range at intake. Parents reported significant change in their understanding of challenging behavior and prediction of children’s behavioral symptoms 3 months into treatment. Furthermore, children’s improvement was predicted by their parents’ increased understanding that cognitive skill deficits are responsible for challenging behavior. These results suggest that using CPS in community-based, outpatient family treatment is effective for helping children who exhibit a range of clinical symptoms. Results provide insights for clinical practice and research on CPS.

Keywords

Collaborative Problem Solving outpatient externalizing challenging behavior

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References

American Psychiatric Association. (2013). Disruptive, impulse-control, and conduct disorders. In: Diagnostic and statistical manual of mental disorders (5th ed.)

Blue Menu of evidence-based interventions for youth. (2018). May 2019, from https://www.practicewise.com/Community/BlueMenu

Burlingame

G. M.

Dunn

Hill

Cox

Wells

M. G.

Lambert

M. J.

Brown

G. S.

(2004). Administration and scoring manual for the Y-OQ-30.2. Youth. American Professional Credentialing Services.

Castro-Schilo

Grimm

K. J.

(2018). Using residualized change versus difference scores for longitudinal research. Journal of Social and Personal Relationships, 35(1), 32–58. https://doi.org/10.1177/0265407517718387

Deci

E. L.

Koestner

Ryan

R. M.

(1999). A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychological Bulletin, 125(6), 627–700. https://doi.org/10.1037/0033-2909.125.6.627

Dedousis-Wallace

Drysdale

S. A.

McAloon

Ollendick

T. H.

(2020). Parental and familial predictors and moderators of parent management treatment programs for conduct problems in youth. Clinical Child and Family Psychology Review, 24(1), 1–28. https://doi.org/10.1007/s10567-020-00330-4

Dunn

T. W.

Burlingame

G. M.

Walbridge

Smith

Crum

M. J.

(2005). Outcome assessment for children and adolescents: psychometric validation of the youth outcome questionnaire 30.1 (Y-OQ®-30.1). Clinical Psychology & Psychotherapy: An International Journal of Theory & Practice, 12(5), 388–401. https://doi.org/10.1002/cpp.461

Epstein

Saltzman-Benaiah

(2010). Parenting children with disruptive behaviours: Evaluation of a collaborative problem solving pilot program. Journal of Clinical Psychology Practice, 1(1), 27–40.

Ercole-Fricke

Fritz

Hill

L. E.

Snelders

(2016). Effects of a collaborative problem-solving approach on an inpatient adolescent psychiatric unit. Journal of Child and Adolescent Psychiatric Nursing, 29(3), 127–134. https://doi.org/10.1111/jcap.12149

10.

Erskine

H. E.

Norman

R. E.

Ferrari

A. J.

Chan

G. C.

Copeland

W. E.

Whiteford

H. A.

Scott

J. G.

(2016). Long-term outcomes of attention-deficit/hyperactivity disorder and conduct disorder: A systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry, 55(10), 841–850. https://doi.org/10.1016/j.jaac.2016.06.016

11.

Felitti

V. J.

Anda

R. F.

Nordenberg

Williamson

D. F.

Spitz

A. M.

Edwards

Koss

M. P.

Marks

J. S.

(1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/s0749-3797(98)00017-8

12.

Gerard

A. B.

(1994). Parent-child relationship inventory. Western psychological services.

13.

Greene

R. W.

Ablon

J. S.

(2005). Treating explosive kids: The collaborative problem-solving approach. Guilford Press.

14.

Greene

R. W.

Ablon

J. S.

Goring

J. C.

Raezer-Blakely

Markey

Monuteaux

M. C.

Henin

Edwards

Rabbitt

(2004). Effectiveness of collaborative problem solving in affectively dysregulated children with oppositional-defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72(6), 1157–1164. https://doi.org/10.1037/0022-006X.72.6.1157

15.

Harris

P. A.

Taylor

Thielke

Payne

Gonzalez

Conde

J. G.

(2009). Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. Journal of Biomedical Informatics, 42(2), 377–381. https://doi.org/10.1016/j.jbi.2008.08.010

16.

Heath

G. H.

Fife-Schaw

Wang

Eddy

C. J.

Hone

M. J. G.

Pollastri

A. R.

(2020). Collaborative problem solving reduces children’s emotional and behavioral difficulties and parenting stress: Two key mechanisms. Journal of Clinical Psychology, 76(7), 1226–1240. https://doi.org/10.1002/jclp.22946

17.

Johnson

Ostlund

Fransson

Landgren

Nasic

Kadesjö

Gillberg

Fernell

(2012). Attention-deficit/hyperactivity disorder with oppositional defiant disorder in Swedish children-an open study of collaborative problem solving: Collaborative problem solving for ADHD and ODD. Acta Paediatrica, 101(6), 624–630. https://doi.org/10.1111/j.1651-2227.2012.02646.x

18.

Leichsenring

(2004). Randomized controlled versus naturalistic studies: A new research agenda. Bulletin of the Menninger Clinic, 68(2), 137–151. https://doi.org/10.1521/bumc.68.2.137.35952

19.

Liming

K. W.

Grube

W. A.

(2018). Wellbeing outcomes for children exposed to multiple adverse experiences in early childhood: A systematic review. Child and Adolescent Social Work Journal, 35(4), 317–335. https://doi.org/10.1007/s10560-018-0532-x

20.

Lundahl

Risser

H. J.

Lovejoy

M. C.

(2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26(1), 86–104. https://doi.org/10.1016/j.cpr.2005.07.004

21.

Murrihy

R. C.

Kidman

A. D.

Ollendick

T. H.

(2010). Clinical handbook of assessing and treating conduct problems in youth. Springer.

22.

Nock

M. K.

Kazdin

A. E.

Hiripi

Kessler

R. C.

(2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: Results from the national comorbidity survey replication. Journal of Child Psychology and Psychiatry, 48(7), 703–713. https://doi.org/10.1111/j.1469-7610.2007.01733.x

23.

Pinheiro

Bates

DebRoy

Sarkar

, & R Core Team. (2021). Nlme: Linear and nonlinear mixed effects models. Parasites; Vectors 3.1–153.

24.

Pollastri

A. R.

Epstein

L. D.

Heath

G. H.

Ablon

J. S.

(2013 Jul-Aug). The collaborative problem solving approach: Outcomes across settings. Harvard Review of Psychiatry, 21(4), 188–199. https://doi.org/10.1097/HRP.0b013e3182961017

25.

Reef

van Meurs

Verhulst

F. C.

van der Ende

(2010). Children’s problems predict adults’ DSM-IV disorders across 24 years. Journal of the American Academy of Child and Adolescent Psychiatry, 49(11), 1117–1124. https://doi.org/10.1016/j.jaac.2010.08.002

26.

Reyno

S. M.

McGrath

P. J.

(2006). Predictors of parent training efficacy for child externalizing behavior problems: A meta-analytic review. Journal of Child Psychology and Psychiatry, 47(1), 99–111. https://doi.org/10.1111/j.1469-7610.2005.01544.x

27.

RStudio Team. (2018). RStudio: Integrated development for R. RStudio Inc.

28.

Saito

(2020). When is it most appropriate to control for initial scores? A comparison of examination methods for two-wave panel survey data changes. The Quantitative Methods for Psychology, 16(5), 457–466. https://doi.org/10.20982/tqmp.16.5.p457

29.

Wang

Pollastri

A. R.

(2019). User’s guide to the collaborative problem solving adherence & impact measures (CPS-AIMs). Think:Kids Massachusetts General Hospital; Harvard Medical School.

30.

Wang

Pollastri

A. R.

Vuijk

P. J.

Hill

E. N.

Lee

B. A

Samkavitz

Braaten

E. B.

Ablon

J. S.

Doyle

A. E.

(2019). Reliability and validity of the thinking skills inventory, a screening tool for cross-diagnostic skill deficits underlying youth behavioral challenges. Journal of Psychopathology and Behavioral Assessment, 41(1), 144–159. https://doi.org/10.1007/s10862-018-9703-5

31.

Warren

J. S.

Nelson

P. L.

Mondragon

S. A.

Baldwin

S. A.

Burlingame

G. M.

(2010). Youth psychotherapy change trajectories and outcomes in usual care: Community mental health versus managed care settings. Journal of Consulting and Clinical Psychology, 78(2), 144–155. https://doi.org/10.1037/a0018544

32.

Weisz

J. R.

Weiss

Han

S. S.

Granger

D. A.

Morton

(1995). Effects of psychotherapy with children and adolescents revisited: A meta-analysis of treatment outcome studies. Psychological Bulletin, 117(3), 450–468. https://doi.org/10.1037/0033-2909.117.3.450Author biographies