Clinical trial NCT05086328: The Effect of Nonviolent Resistance in Parent Group Training in Child Psychiatric Care
Official title: The Effect of Nonviolent Resistance in Parent Group Training in Child Psychiatric Care
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Helplessness, Learned
Family Conflict
Mentalising
Parenting
Lead sponsor: Universitair Ziekenhuis Brussel
Sponsor class: OTHER
First posted: 2021-10-20
Enrollment: 64
Sex: ALL
Minimum age (years): 21
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: - parents of child on the waiting list or already admitted for help in the child psychiatric clinic at the study location, with specific parental stress related to helplessness

Brief summary: In a Flemish sample of parents of children with psychiatric problems, this study evaluates the effect of a parent group training based on nonviolent resistance on family functioning, parenting variables and mental states of the parents, pre- and post-training.

Detailed description: Nonviolent Resistance (NVR) is an intervention method for families and teams that are suffering from helplessness and hopelessness. By empowering individuals through specific focus points and techniques, they can re-establish their role as authority figures for the child. The child, exhibiting dangerous and/or coercive behavior, can feel reconnected and guided.

Previous research has shown that parents score higher on General family functioning, Affective reactions and affective involvement, and Role definitions, but not Behavioral control, Problem solving and Communication. Positive effects were visible at a follow up moment, three months later. Parents reported significantly lower on anxiety for the aggression of their child, the self-efficiency about parental capacities and received social support. General parenting stress diminished significantly. A control group showed no such significant changes.

Participants with specific problems and waiting to be admitted in the residential ward at the study location can receive pre-care, in the form of a parental group training based on NVR. In six two weekly sessions, combined with intermediate telephone support and home assignments, parents are involved in important parent-child-oriented aspects.

This study will evaluate the effect of the training in a Flemish sample, focusing on family functioning, parenting variables and reflective functioning of the parents, pre- and post-training. T1 is at the time between invitation to participate and the first session; T2 is in the first week after the last session (T1 + 12 to 14 weeks); T3 is at three months after the last session; T4 is at six months after the last session.

The following primary outcomes are expected after the parent group:

* More behavior and mental states pointing towards NVR
* More use of adequate emotion regulation
* Less behavioral problems in the child

Secondary outcomes are expected, according to previous research measuring indirect effects of NVR treatment

* More adequate attunement to child
* More cohesion and structure in the family
* More adequate parenting behavior
* Less stress and burdening for parents

The investigators also expect parents with a more secure attachment style to benefit more (T2) and longer (T3 and T4) from the training.

Eligibility criteria: Inclusion Criteria:

Parents engage in the NVR training of the child psychiatric clinic at the study location for at least 5 out of 6 training sessions

Exclusion Criteria:

* insufficient understanding of Dutch/Flemish language
* simultaneously following a different parent group treatment, external to the study location

Primary outcomes:
measure: Change from baseline mean scores in four domains of Nonviolent Resistance as measured with the Parental Anchoring Scale (Flemish version)
timeFrame: T1 baseline = 1 to 2 weeks before first session; T2 = T1 + 12 to 14 weeks; T3 = T2 + three months; T4 = T2 + six months
measure: Change from baseline mean scores in child behavior as measured with the Child Behavior Checklist (CBCL)
timeFrame: T1 baseline = 1 to 2 weeks before first session; T2 = T1 + 12 to 14 weeks; T3 = T2 + three months; T4 = T2 + six months
measure: Change from baseline mean scores in emotion regulation as measured with the Emotion Regulation Questionnaire (ERQ)
timeFrame: T1 baseline = 1 to 2 weeks before first session; T2 = T1 + 12 to 14 weeks; T3 = T2 + three months; T4 = T2 + six months
Secondary outcomes:
measure: Change from baseline mean scores in attunement to the child as measured with the Parental Reflective Functioning Scale (PRFQ)
timeFrame: T1 baseline = 1 to 2 weeks before first session; T2 = T1 + 12 to 14 weeks; T3 = T2 + three months; T4 = T2 + six months
measure: Change from baseline mean scores in family functioning as measured with the Questionnaire for Family Functioning (VGFO)
timeFrame: T1 baseline = 1 to 2 weeks before first session; T2 = T1 + 12 to 14 weeks; T3 = T2 + three months; T4 = T2 + six months
measure: Change from baseline mean scores in parental burden as measured with the Parental Burden Questionnaire (OBVL)
timeFrame: T1 baseline = 1 to 2 weeks before first session; T2 = T1 + 12 to 14 weeks; T3 = T2 + three months; T4 = T2 + six months
measure: Change from baseline mean scores in parental behavior as measured with the Short Scale for Parental Behavior (VSOG)
timeFrame: T1 baseline = 1 to 2 weeks before first session; T2 = T1 + 12 to 14 weeks; T3 = T2 + three months; T4 = T2 + six months
Other outcomes:
Locations:
city: Brussel
country: Belgium
facility: UZ Brussel
Study officials:
affiliation: Universitair Ziekenhuis Brussel
name: Bart Colson, MA
role: PRINCIPAL_INVESTIGATOR
References:
citation: Sherman, E. (2018). Group-Based Nonviolent Resistance Program: Development of a Short-Term Intervention and Preliminary Assessment of Its Feasibility and Acceptance. Tel Aviv University, Master Thesis
citation: Omer H, Lebowitz ER. Nonviolent Resistance: Helping Caregivers Reduce Problematic Behaviors in Children and Adolescents. J Marital Fam Ther. 2016 Oct;42(4):688-700. doi: 10.1111/jmft.12168. Epub 2016 Jun 13.
citation: Kiliçarslan, S. (2019). The Effect of the Non-violent Resistance Program for the Parents of Children with Violent Behaviors. Kastamonu Education, 27(2), 701-716. https://doi.org/10.24106/kefdergi.2691
citation: Kiliçarslani, S., Ördem, S., Taltekin, A. & Ardiç, R. (2019). The Effect of Non-Violent Resistance Program on Family Relationships and Parentship Perceptions of Parents. PAU Journal of Education, 45, 211-234. doi: 10.9779/PUJE.2018.230
citation: Schorr-Sapir I, Gershy N, Apter A, Omer H. Parent training in non-violent resistance for children with attention deficit hyperactivity disorder: a controlled outcome study. Eur Child Adolesc Psychiatry. 2022 Jun;31(6):929-938. doi: 10.1007/s00787-021-01723-8. Epub 2021 Feb 2.
citation: Van Holen F, Vanderfaeillie J, Omer H. Adaptation and Evaluation of a Nonviolent Resistance Intervention for Foster Parents: A Progress Report. J Marital Fam Ther. 2016 Apr;42(2):256-71. doi: 10.1111/jmft.12125. Epub 2015 Apr 24.