Making ‘what works’ work: A meta-analytic study of the effect of treatment integrity on outcomes of evidence-based interventions for juveniles with antisocial behavior

Goense, Pauline; Assink, Mark; Stams, Geert Jan; Boendermaker, Leonieke; Hoeve, Machteld

doi:10.1016/j.avb.2016.08.003

Cited by 49 publications

(35 citation statements)

References 48 publications

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“…A small but statistically significant relationship was identified between therapist adherence and youth outcome, suggesting that implementing the appropriate components of therapy plays a small role in child and adolescent therapeutic practice. This finding is in line with a previous qualitative review of child and adolescent mental health intervention and prevention [17], and with a meta-analysis of intervention for juvenile antisocial behaviour [19], although it appears inconsistent with the meta-analysis by Webb et al [16]. This suggests, if taken at face value, that therapist adherence may be marginally more influential in child and family settings compared with adult individual therapy settings.…”

Section: Discussionsupporting

confidence: 69%

“…A recent systematic review of child and adolescent cognitive behavioural therapy concluded that the understanding of the relationships between adherence or competence and outcome remains inconclusive [18]. In contrast, a recent meta-analysis has indicated a relationship between integrity and outcome in intervention for juvenile antisocial behaviour [19]. These findings suggest, in line with inferences drawn based on individual studies, that implementation may be associated with outcome in some child and adolescent intervention approaches but not others.…”

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confidence: 99%

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Systematic literature review and meta-analysis of the relationship between adherence, competence and outcome in psychotherapy for children and adolescents

Collyer

Eisler

Woolgar

2019

Eur Child Adolesc Psychiatry

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The extent to which therapist adherence to guidelines and clinician skill or competence may play a role in the prediction of therapeutic outcomes remains inconclusive. This systematic literature review and meta-analysis considers whether adherence or competence predicts youth outcome in child and adolescent psychotherapy, and whether there are any identifiable factors which moderate the strength or direction of this relationship. A systematic literature search identified 35 studies in 52 papers. The studies contained 29 effect sizes for the relationship between adherence and outcome, while nine effect sizes were extracted for competence, and a further five effects measured a composite of adherence and competence constructs, referred to as fidelity in this report. The meta-analysis indicated a small but significant relationship between therapist adherence and outcome, although the small size of effect suggests that outcomes are likely to be more strongly associated with factors other than adherence. No significant relationship was identified between competence or composite fidelity and outcome. Although variance was observed in effect sizes, no significant moderation by client group, intervention type, or implementation measure informant was identified. Further study is needed to understand the specific circumstances under which adherence and outcome are related.

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Section: Discussionsupporting

confidence: 69%

mentioning

confidence: 99%

Systematic literature review and meta-analysis of the relationship between adherence, competence and outcome in psychotherapy for children and adolescents

Collyer

Eisler

Woolgar

2019

Eur Child Adolesc Psychiatry

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“…The intercoder reliability study on the OAT-A and EAT-A is a first step to enable systematic AT evaluation with a child diagnosed ASD. As indicated before there is until now not a will contribute to improvement of treatment results as was documented in several studies (Goense et al 2016;Town et al, 2012).…”

Section: Recommendationsmentioning

confidence: 91%

“…These consensus-based elements are related to the art making processes of children diagnosed with ASD and to the behaviour of the art therapists. Both 'areas of defined typical elements' are assumed to be crucial for achieving positive outcomesGoense et al, 2016; Van Lith, Stallings, & Harris, 2017; Van Yperen, Van der Steege, Addink, & Boendermaker, 2010). Consensus-based elements typical for AT with children diagnosed ASD can contribute to a 'promising' level of practice-based evidence (Van Yperen, Veerman, & Bijl, 2017).…”

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confidence: 99%

Art Therapy for Children Diagnosed with Autism Spectrum Disorders: Development and First Evaluation of a Treatment Programme

Schweizer¹

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12 the third circle. The outer circle frames the treatment Outcomes. The COAT-model and the descriptive results were used as building blocks in further studies. Research sub-question 2. Based on the literature, which typical elements in art therapy for children diagnosed with ASD can be identified that contribute to positive treatment outcomes? Children diagnosed with ASD are often referred to AT. The therapy seems promising for helping them with problems in the areas of social behavior, learning skills, and focusing attention (Schweizer, 2014; Teeuw, 2011). Also, there are some indications that improvements are generalized at home and in the classroom (Pioch, 2010). In this second study we systematically explored what evidence could be found in the research literature for 'working' elements of AT for children diagnosed with ASD. A search for intervention studies published between 1995-2012 was executed with relevant keywords (art, art therapy, Autism Spectrum Disorder, child, effect, outcome) using well-known databases: Cochrane, ERIC, MEDLINE, PubMED, psychINFO, ERIC, and Google. Assessment studies were excluded. The search did not find any intervention study that matched the criteria, also meaning that no systematic reviews, meta-analyses or RCTs could be identified. What we did find was a number of well-documented publications concerning art therapy for individual children diagnosed with ASD in the form of case descriptions that enabled a thorough content analysis. This analysis was structured according to the four categories of the COAT-model and resulted in a second description of promising elements of art therapy with children diagnosed with ASD. As a result of study 1 and 2 a substantial number of typical elements was identified. Our next aim was to compute the degree of consensus in a sample of art therapists and referrers regarding the relevance and applicability of these elements in daily practice. From the resulting list of consensus-based items two measuring instruments were developed for respectively observing the child's and the therapist's behavior during AT. This was because there was no instrument that could be used to monitor the behaviors of the main people involved in AT: the child and the therapist. Research sub-question 3. To what extent is there consensus among art therapists and referrers regarding the relevance and applicability in daily practice of typical elements of art therapy with children diagnosed ASD, identified in studies 1 and 2? 17 13 The scope of the third study was to determine the degree of consensus among experienced art therapists and referrers about the relevance and applicability of typical elements of art therapy with children diagnosed ASD. The input was the 'longlist' of elements (items) obtained from studies 1 and 2. For this third study the Delphi methodology was applied using a mixed-methods design. Additionally, a Focus group session was conducted to clarify some contradictory results from the Delphi study. The result was a 'shortlist' of elements with face valid...

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“…Program fidelity-the extent to which a program or service is delivered in the way it was prescribed to be-is a core indicator of implementation success (Breitenstein et al, 2010;Kramer & Burns, 2008). Systematic and meta-analytic reviews consistently report high levels of fidelity to be linked with better client outcomes; conversely, low levels of fidelity were associated with an absence of positive treatment effects (Durlak & DuPre, 2008;Goense, Assink, Stams, Boendermaker, & Hoeve, 2016). Hence, without evidence of program fidelity, it is not possible to attribute improvements in client outcomes to program effects.…”

Section: Implementation: Concepts and Definitionsmentioning

confidence: 99%

The Implementation of Functional Family Therapy (FFT) as an Intervention for Youth Probationers in Singapore

Gan

Zhou

Hoo

et al. 2018

J Marital Family Therapy

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Family functioning is predictive of youth recidivism in Singapore. However, there is a lack of family based interventions for youth offenders on community probation. Evidence-based family interventions developed in Western populations, such as Functional Family Therapy (FFT), have been found to be effective in mitigating subsequent youth criminal behavior. However, no study has examined whether such interventions can be implemented and adapted for use in Eastern cultures. Thus, this paper sought to detail the implementation of FFT in Singapore. Rationale for the adoption of FFT is discussed, and key activities undertaken during the first 18 months of implementation are described. Preliminary data suggest that initial implementation efforts were successful. Challenges encountered, and implications in relation to the broader literature are discussed.

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Making ‘what works’ work: A meta-analytic study of the effect of treatment integrity on outcomes of evidence-based interventions for juveniles with antisocial behavior

Cited by 49 publications

References 48 publications

Systematic literature review and meta-analysis of the relationship between adherence, competence and outcome in psychotherapy for children and adolescents

Systematic literature review and meta-analysis of the relationship between adherence, competence and outcome in psychotherapy for children and adolescents

Art Therapy for Children Diagnosed with Autism Spectrum Disorders: Development and First Evaluation of a Treatment Programme

The Implementation of Functional Family Therapy (FFT) as an Intervention for Youth Probationers in Singapore

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