Nutzungsbedingungen Summary Effectiveness of Early Prevention Programs in Germany: A Systematic Review and a Meta-AnalysisThe number of scientific evaluations of early preventions programs has considerably increased since the foundation of the national center of early prevention in Germany. Early primary and secondary intervention programs are designed to address parents with little children (prenatal until three years) to improve the parent-child-relationship and parental educational competencies. This is thought to enhance child development and to avoid maltreatment in terms of neglect and abuse. During a systematic review, six data-bases were searched for publications on studies about the effectiveness of early prevention programs in Germany between 2003 and 2013. Eight studies were found to fulfill inclusion criteria and were included in a meta-analysis. In comparison to the control groups the early prevention programs had a small effect on maternal symptom burden (d = 0.28), however there was no effect on maternal competences (d = 0.10) and perceived social support (d = -0.06). In addition, there was no effect on psychic child development (d = 0.05) but no effect on the physical development of the children (d = 0.00). Results are discussed as preliminary due to a current lack of a sufficient amount of studies in Germany.Prax. Kinderpsychol. Kinderpsychiat. 62/2013, 598-619 Keywords systematic review -early intervention, meta-analysis -prevention -effectiveness Zusammenfassung
Frühe Hilfen richten sich primär und sekundär präventiv an Eltern mit kleinen Kindern (pränatal bis drei Jahre) und sollen die Beziehungs- und Erziehungskompetenz verbessern, um Kindern gute Entwicklungen zu ermöglichen sowie Kindesmisshandlung und Vernachlässigung zu verhindern. Im Rahmen eines narrativen Review wurden sechs Datenbanken für den Zeitraum zwischen 2003 und 2013 zu Studien zur Programmwirksamkeit Früher Hilfen in Deutschland durchsucht. Die Einschlusskriterien erfüllten 8 Studien, deren Forschungsdesigns, Studiendurchführung und Programmeffekte zusammengefasst wurden. Die Studienqualität wird als heterogen eingeschätzt; besonderer Verbesserungsbedarf wird hinsichtlich der Adhärenzprüfung, der Randomisierung der Teilnehmerinnen und der Kontrolle von Allegiance-Effekten diskutiert.
In this report first results are presented from a pilot study on the Mentalizing Vocational Training that aims to increase the effectiveness of vocational rehabilitation programs with adolescents diagnosed with learning disabilities. The prevention program was based on the hypothesis that adolescents' difficulties in motivation and relationships are related to deficits in mentalizing. Thus, we created a prevention program that supports an enduring mentalizing social system following Twemlow's and Fonagy's suggestions for peaceful schools. The program consists of four modules: a psychoeducative training for all professionals within the rehabilitation program, an ongoing supervision for two selected teams, two mentalizing training groups for selected adolescents and a weekly intervision group for the research team analyzing the organizational perspective. During the pilot study, mentalization interest and attachment styles were assessed from all adolescents and professionals. Additionally, adolescents' mentalization capacities were assessed using an objective videobased test as well as general intelligence. Results showed that participants had significantly more attachment anxiety and avoidance as well as less interest to think about themselves and others in a complex way. Furthermore, participants achieved very low scores in the mentalization test (comparable to the autistic spectrum) which were independent from general cognitive deficits. On the organizational level, professionals appeared to be conflicted about the changes in management towards more economic efficiency and overwhelmed by participants with traumatic backgrounds. This led to a regression of the whole organization on the teleological mode.
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