Clinical Trial of Emotion-Focused Skills Training for Parents

Study Overview
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Brief Summary
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Children with externalizing and internalizing symptoms has been linked to poor emotional competence, problematic understanding and regulation of emotions. A number of recent studies demonstrates the importance of parents' active involvement in the child's recovery process and support the empirical relationship between parenting style and child symptoms. Emotional awareness and acceptance of painful emotional experience in parents leads to reduction in how these emotions are experienced in response to stressors in children. This makes the parent less vulnerable to rumination or suppression of negative emotional experience related to the child. In addition, it releases parents' emotional capacity to be mentally present and emotionally available for their child. Although neuro-affective principles from research have been incorporated in the therapeutic approaches for adults, there are currently no programs that target these mechanisms in working with children with mental health difficulties. Emotion Focused Skills Training (EFST) is an easily administrated, cost efficient treatment program specifically directed towards the parental role in promoting change in children. In this randomized controlled trial, we will compare experiential process oriented EFST with a psycho-educational version of EFST on parents of children aged 6-13 with externalizing or internalizing symptoms. Parents of 236 children will receive a two days course and 6 hours of individually delivered treatment within a 10 weeks period, either with the experiential version of EFST or the psycho-educational version. Feedback regarding outcome on externalizing and internalizing problems will be obtained from parents and teachers at 5 different periods: baseline, treatment completion and at 3, 6 and 9 months follow-up.

Official Title
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Improving Outcome for Children Through Treatment of Their Parents - Comparing Emotion-Focused Parent Skills Training With Emotion Coaching Parent Program for Children With Externalizing and Internalizing Symptoms: a Randomized Controlled Trial

Conditions
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F01.318 Child Rearing, F01.470 Emotions, F01.145.179 Child Behavior

Intervention / Treatment
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* Behavioral: Emotion-Focused Skills Training for Parents - Experiential
* Behavioral: Emotion-Focused Skills Training for Parents - Psychoeducational


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parents of children between 6-13 with either internalizing problems, externalizing problems, or both. An overall final assessment of whether it is likely that the parents will be able to fully participate in the study. Parents who live with the child at least 50% of the time. Parents who agree that they need help and are motivated for the treatment. Parents and children who speak Norwegian Parents who have the time to participate in the intervention program. Parents who are willing to collaborate with the childs school and contact with the school teacher. Exclusion Criteria: Parents: Serious or chronic mental health difficulties such as psychosis, bipolar disorder, organic disorder, ongoing substance abuse, do. documented sexual abuse, serious mental health problems, organic disorder and/or disability in the child.

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 13 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized Clinical Trial
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experiential Condition<br>This group will receive an experiential version of the program Emotion-Focused Skills Training for Parents, meaning they will engage in tasks that are supposed to activate the parents emotional system, providing them with a deeper sense of understanding towards their child. | Behavioral: Emotion-Focused Skills Training for Parents - Experiential<br>* The intervention consists of a 2-day work shop given in a group format, in addition to 6 hours of parent supervision within 6 weeks after the work shop.<br>Behavioral: Emotion-Focused Skills Training for Parents - Psychoeducational<br>* The intervention consists of a 2-day work shop given in a group format, in addition to 6 hours of parent supervision within 6 weeks after the work shop.<br>|
| Active Comparator: Psychoeducational version<br>This group will receive a non-experiential, psychoeducational version of the program Emotion-Focused Skills Training for Parents, meaning they will not engage in tasks that are meant to activate the parents emotional system. | Behavioral: Emotion-Focused Skills Training for Parents - Experiential<br>* The intervention consists of a 2-day work shop given in a group format, in addition to 6 hours of parent supervision within 6 weeks after the work shop.<br>Behavioral: Emotion-Focused Skills Training for Parents - Psychoeducational<br>* The intervention consists of a 2-day work shop given in a group format, in addition to 6 hours of parent supervision within 6 weeks after the work shop.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in SDQ-P 4-17 - Strengths and Difficulties Questionnaire and impact supplement for the parents of 4-17 year olds All 5 subscales and total score will be used. |  | Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up | 
| Change in ASEBA Child Behavior Checklist for Ages 6-18 All eight subscales and total scores will be used. |  | Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up | 
| Change in ASEBA - Child Behavior Checklist - Teacher Report Form All eight subscales and total scores will be used. |  | Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Outcome Questionnaire 45, Version 2, for the parents | Outcome questionnaire designed to evaluate a psychotherapy client's progress initially and throughout treatment. | Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up | 
| Difficulties in Emotion Regulation Scale |  | Pre, post, 3 months, 6 months, 9 monthsPre, post (0 months after completed intervention), 3, 6 and 9 months follow up | 
| Forms of Self-Criticising/Attacking & Self-Reassuring Scale All 3 subscales will be used: Inadequate self, Hated self, Reassured self. |  | Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up |