Clinical trial NCT02896426: Collaborative Problem Solving vs. Positive Solutions for Families in Preschool Parent Groups
Official title: Comparison of Collaborative Problem Solving (CPS) and Positive Solutions for Families Groups for Parents of Head Start Preschoolers
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Child Behavior
Problem Behavior
Family Conflict
Keywords: Parent training
Preschoolers
Behavior problems
Oppositional Defiant Disorder
ODD
Conduct Disorder
CD
Children
Parenting
Collaborative Problem Solving
CPS
Disruptive behavior
Lead sponsor: Massachusetts General Hospital
Sponsor class: OTHER
Collaborators: name: Caplan Foundation for Early Childhood
First posted: 2016-09-12
Enrollment: 22
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The main objectives of this study are to evaluate the feasibility, acceptability, and effects of a CPS parent group on outcomes for a sample of parents of children ages 3 to 5 compared to outcomes after attending a parenting group that promotes behavioral (operant) parenting. We hypothesize that guardians in the CPS group will report a better understanding of how neurocognitive skills relate to children's behaviors, greater improvements in child functioning and behavior, and greater reductions in parents' stress than those in the comparison group.

Detailed description: Collaborative Problem Solving (CPS) is an evidence-based approach for treating children with behavioral challenges. Unlike traditional models of discipline that use power, control and incentives to facilitate compliance, CPS does not assume that a challenging child lacks motivation for compliance, but instead that the child is motivated to behave well, but simply cannot consistently do so, due to lagging skills in one or more critical neurocognitive domains, such as those related to language and communication skills, attention and working memory skills, emotion- and self-regulation skills, cognitive flexibility skills, and/or social thinking skills. The goal of the intervention is to improve these lagging neurocognitive skills by helping adults and children work toward mutually satisfactory solutions to problems, thereby enhancing flexibility and frustration tolerance in both interaction partners. Any caregiver can use CPS with any child, and CPS can be taught to mental health providers (e.g., therapists, direct care staff), educators (e.g., teachers, administrators), or parents. Common ways to teach CPS to parents include family therapy (one provider teaching one family) or in parent group training (one provider teaching six to ten parents).

Although preschool-aged children have been included in past CPS-related research, they have not been studied separately, and research has not assessed the appropriateness of the current CPS approach for very young children. To address this gap in research, this study will support the development of a parent group curriculum specifically targeting guardians of preschool-aged children, as well as a randomized efficacy trial to evaluate the feasibility, acceptability, and effects of a CPS parent group. Outcome measures from the CPS group will be compared with those from a group that promotes operant behavioral parenting.

Approximately sixty participating guardians will be randomly assigned to attend one of two types of weekly 2-hour groups, each lasting six weeks: either a Collaborative Problem Solving group (N=30; 3 groups) or a Positive Solutions for Families group, a group routinely offered at Head Start programs (N=30; 3 groups). Participants will complete surveys prior to beginning the groups (baseline), upon completion of the group sessions (discharge), and six months after the conclusion of the groups (follow up). Results from these surveys will be compared between groups.

Eligibility criteria: Inclusion Criteria:

* Guardian of a child between the ages of three and five currently enrolled at participating Head Start center
* Speaking and writing English at level necessary to complete study requirements

Exclusion Criteria:

* A diagnosis of significant Autism that currently impacts day to day functioning
* A diagnosis of a psychotic disorder including schizophrenia, schizoaffective disorder, schizophreniform disorder
* An intellectual disability that impairs day to day functioning
* Participation in a similar parenting group at the Head Start site within the last year

Primary outcomes:
measure: Feasibility of a CPS group for parents of preschool-age children
timeFrame: 6 months (immediately after group and 6 months after the group)
Secondary outcomes:
measure: Impact of parenting groups on parenting style
timeFrame: 8 months (changes from baseline, immediately after group, and 6 months after the group)
measure: Impact of parenting groups on parent emotion regulation
timeFrame: 8 months (changes from baseline, immediately after group, and 6 months after the group)
measure: Impact of parenting groups on the parent child relationship
timeFrame: 8 months (changes from baseline, immediately after group, and 6 months after the group)
measure: Impact of parenting groups on the parent philosophy
timeFrame: 8 months (changes from baseline, immediately after group, and 6 months after the group)
measure: Acceptability of a CPS group for parents of preschool-age children
timeFrame: 8 months (changes from baseline, immediately after group, and 6 months after the group)
measure: Parent satisfaction with a CPS group for preschool-aged children
timeFrame: 8 months (changes from baseline, immediately after group, and 6 months after the group)
measure: Parent satisfaction with a CPS group for preschool-aged children
timeFrame: 8 weeks (immediately after conclusion of group)
Other outcomes:
Locations:
Study officials:
affiliation: Think:Kids at Massachusetts General Hospital
name: Alisha R Pollastri, Ph. D.
role: PRINCIPAL_INVESTIGATOR
References: