Multiple Family Groups to reduce child disruptive behavior difficulties: Moderating effects of child welfare status on child outcomes

Abstract

Children who remain at home with their permanent caregivers following a child welfare (CW) involvement (e.g., investigation, out-of-home placement) manifest high rates of behavioral difficulties, which is a risk factor for further maltreatment and out-of-home placement if not treated effectively. A recently tested Multiple Family Group (MFG) service delivery model to treat youth Disruptive Behavior Disorders (DBDs) has demonstrated effectiveness in improving child behavior difficulties among hard-to-engage, socioeconomically disadvantaged families by addressing parenting skills, parent-child relationships, family communication and organization, social support, and stress. This exploratory study examines whether child behavioral outcomes for MFG differ for families with self-reported lifetime involvement in CW services compared to other families, as families with CW involvement struggle with additional stressors that can diminish treatment success. Youth (aged 7–11) and their families were assigned to MFG or services as usual (SAU) using a block comparison design. Caregivers reported on child behavior, social skills, and functional impairment. Mixed effects regression modeled multilevel outcomes across 4 assessment points (i.e., baseline, mid-test, post-test, 6 month follow-up). Among CW-involved families, MFG participants reported significantly reduced child oppositional defiant disorder symptoms at 6-month follow-up compared with SAU participants. No other differences were found in the effect of MFG treatment between CW and non-CW involved families. Findings suggest that MFG may be as effective in reducing child behavior difficulties for both CW and non-CW involved families. As a short-term, engaging, and efficient intervention, MFG may be a particularly salient service offering for families involved in the CW system.

Multiple family therapy for Chinese families of children with attention deficit hyperactivity disorder (ADHD): treatment efficacy from the children’s perspective and their subjective experiences

“…The positive changes brought about by an MFT have been shown for families of children with mood disorders (Fristad, Goldberg-Arnold and Gavazzi, 2003), children with antisocial problems in London (Morris et al, 2013), youths with severe emotional disturbances (Ruffolo, Kuhn and Evans, 2005) and youths with disruptive behaviour disorders in New York (Gopalan et al, 2015). However, the results of the studies were predominantly based on the parents' perspectives.…”

Treatment Efficacy of Multiple Family Therapy for Chinese Families of Children with Attention Deficit Hyperactivity Disorder

“…In the study by Gopalan et al. (), MFT had a positive effect on families ( n = 129) that have been involved in matters of child welfare (e.g., investigation, out‐of‐home placement); they reported significantly reduced child oppositional defiant disorder symptoms at a 6‐month follow‐up compared with those receiving only the usual services.…”

“…The treatment efficacy of MFT has been shown for Chinese families in Hong Kong who have a member suffering from schizophrenia (Chien & Chan, ) but the results of the study cannot be generalized to families of children with ADHD. Notwithstanding this, the treatment outcomes of MFT have been shown in families of children with antisocial problems in London (mean age = 8.39) (Morris, Huray, Skagerberg, Gomes, & Ninteman, ), in American parents/primary caregivers of youth (mean age = 11.47) with severe emotional disturbances (Ruffolo, Kuhn, & Evans, ), and in hard‐to‐engage, socioeconomically disadvantaged families of youths with Disruptive Behavior Disorders in New York (Gopalan et al., ). In the study by Morris et al.…”

“…Parents/primary caregivers in the control (n = 36) and experimental groups (n = 58) had showed no significant differences in their perceived social support and problemsolving skills. In the study by Gopalan et al (2015), MFT had a positive effect on families (n = 129) that have been involved in matters of child welfare (e.g., investigation, out-ofhome placement); they reported significantly reduced child oppositional defiant disorder symptoms at a 6-month follow-up compared with those receiving only the usual services.…”

“…The treatment efficacy of MFT has been shown for Chinese families in Hong Kong who have a member suffering from schizophrenia (Chien & Chan, 2004) but the results of the study cannot be generalized to families of children with ADHD. Notwithstanding this, the treatment outcomes of MFT have been shown in families of children with antisocial problems in London (mean age = 8.39) (Morris, Huray, Skagerberg, Gomes, & Ninteman, 2013), in American parents/ primary caregivers of youth (mean age = 11.47) with severe emotional disturbances (Ruffolo, Kuhn, & Evans, 2005), and in hard-to-engage, socioeconomically disadvantaged families of youths with Disruptive Behavior Disorders in New York (Gopalan et al, 2015). In the study by Morris et al(2013), when compared to the control group (n = 28), parents of the experimental group (n = 50) who had received MFT reported statistically and clinically significant improvements in their children's symptoms; their family functioning remained stable, while the family functioning of the control group showed significant deterioration.…”