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The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial.

Overbeek MM, de Schipper JC, Lamers-Winkelman F, Schuengel C - Trials (2012)

Bottom Line: The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program.Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect.An important question for prevention programs is therefore to what extent a specific focus on potential psychotrauma is useful.

View Article: PubMed Central - HTML - PubMed

Affiliation: VU University, Department of Clinical Child and Family Studies, Amsterdam, The Netherlands. m.m.overbeek@vu.nl

ABSTRACT

Background: Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors.

Methods/design: This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140) are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health) care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program starts (T1), and one week (T2) and six months (T3) after finishing the program. Both intention-to-treat and completer analyses will be done.

Discussion: Adverse outcomes after witnessing interparental violence are highly diverse and may be explained by multiple risk factors. An important question for prevention programs is therefore to what extent a specific focus on potential psychotrauma is useful. This trial may point to several directions for optimizing public health response to children's exposure to interparental violence.

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Research procedure. After informed consent is obtained, 2/3 of all parent-child dyads will be randomized into the experimental arm and 1/3 into the control arm. Parents and children are asked to fill out questionnaires (parent: TSCYC, CBCL, Questionnaire about duration and severity of domestic violence, demographic questionnaire, IES-R, HADS, PSI; child: CDI, TSCC, Questionnaire for children how to cope with difficult situations) at the first assessment (T1). A week later the program starts for all parents and children. One week (T2) and six months (T3) after the end of the program parents and children who take part in the study are again invited to fill out questionnaires and participate in two observation tasks (FIT and AEED). To check up on parents in the period between T2 and T3, parents are contacted by phone two times. At all assessments the teacher is also sent a questionnaire.
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Figure 1: Research procedure. After informed consent is obtained, 2/3 of all parent-child dyads will be randomized into the experimental arm and 1/3 into the control arm. Parents and children are asked to fill out questionnaires (parent: TSCYC, CBCL, Questionnaire about duration and severity of domestic violence, demographic questionnaire, IES-R, HADS, PSI; child: CDI, TSCC, Questionnaire for children how to cope with difficult situations) at the first assessment (T1). A week later the program starts for all parents and children. One week (T2) and six months (T3) after the end of the program parents and children who take part in the study are again invited to fill out questionnaires and participate in two observation tasks (FIT and AEED). To check up on parents in the period between T2 and T3, parents are contacted by phone two times. At all assessments the teacher is also sent a questionnaire.

Mentions: Each group is randomly assigned to either the intervention or the control arm. Parents and children are given the details about the program into which they are randomized. Parents and children who participate in the study are invited to the setting (e.g. community centre, mental health clinic) at which the program (intervention or control) takes place one week before the program starts. They are asked to fill out questionnaires (T1). A week later the program starts for all parents and children. One week (T2) and six months (T3) after the end of the program parents and children who take part in the study are again invited to fill out questionnaires and participate in two observation tasks. If parents or children have trouble filling out the questionnaires, a trained masters student or an interpreter will assist. To check up on parents in the period between T2 and T3, parents are contacted by phone two times. Figure 1 shows the different stages of the research procedure and gives an overview of the instruments used at each assessment.


The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial.

Overbeek MM, de Schipper JC, Lamers-Winkelman F, Schuengel C - Trials (2012)

Research procedure. After informed consent is obtained, 2/3 of all parent-child dyads will be randomized into the experimental arm and 1/3 into the control arm. Parents and children are asked to fill out questionnaires (parent: TSCYC, CBCL, Questionnaire about duration and severity of domestic violence, demographic questionnaire, IES-R, HADS, PSI; child: CDI, TSCC, Questionnaire for children how to cope with difficult situations) at the first assessment (T1). A week later the program starts for all parents and children. One week (T2) and six months (T3) after the end of the program parents and children who take part in the study are again invited to fill out questionnaires and participate in two observation tasks (FIT and AEED). To check up on parents in the period between T2 and T3, parents are contacted by phone two times. At all assessments the teacher is also sent a questionnaire.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369208&req=5

Figure 1: Research procedure. After informed consent is obtained, 2/3 of all parent-child dyads will be randomized into the experimental arm and 1/3 into the control arm. Parents and children are asked to fill out questionnaires (parent: TSCYC, CBCL, Questionnaire about duration and severity of domestic violence, demographic questionnaire, IES-R, HADS, PSI; child: CDI, TSCC, Questionnaire for children how to cope with difficult situations) at the first assessment (T1). A week later the program starts for all parents and children. One week (T2) and six months (T3) after the end of the program parents and children who take part in the study are again invited to fill out questionnaires and participate in two observation tasks (FIT and AEED). To check up on parents in the period between T2 and T3, parents are contacted by phone two times. At all assessments the teacher is also sent a questionnaire.
Mentions: Each group is randomly assigned to either the intervention or the control arm. Parents and children are given the details about the program into which they are randomized. Parents and children who participate in the study are invited to the setting (e.g. community centre, mental health clinic) at which the program (intervention or control) takes place one week before the program starts. They are asked to fill out questionnaires (T1). A week later the program starts for all parents and children. One week (T2) and six months (T3) after the end of the program parents and children who take part in the study are again invited to fill out questionnaires and participate in two observation tasks. If parents or children have trouble filling out the questionnaires, a trained masters student or an interpreter will assist. To check up on parents in the period between T2 and T3, parents are contacted by phone two times. Figure 1 shows the different stages of the research procedure and gives an overview of the instruments used at each assessment.

Bottom Line: The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program.Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect.An important question for prevention programs is therefore to what extent a specific focus on potential psychotrauma is useful.

View Article: PubMed Central - HTML - PubMed

Affiliation: VU University, Department of Clinical Child and Family Studies, Amsterdam, The Netherlands. m.m.overbeek@vu.nl

ABSTRACT

Background: Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors.

Methods/design: This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140) are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health) care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program starts (T1), and one week (T2) and six months (T3) after finishing the program. Both intention-to-treat and completer analyses will be done.

Discussion: Adverse outcomes after witnessing interparental violence are highly diverse and may be explained by multiple risk factors. An important question for prevention programs is therefore to what extent a specific focus on potential psychotrauma is useful. This trial may point to several directions for optimizing public health response to children's exposure to interparental violence.

Show MeSH
Related in: MedlinePlus