Child-Focused Family Therapy: Behavioural Family Therapy Versus Brief Family Therapy

We examined the effectiveness of behavioural family therapy (following the treatment agenda outlined in Fleischman, Horne and Arthur, 1983) and brief family therapy (following the procedures outlined in Fisch, Weakland and Segal, 1985), in the treatment of child psychological disorders. The parents of the 49 children referred to the outpatient unit of a children's hospital completed the Child Behavior Checklist (CBCL) (Achenbach and Edelbrock, 1983). Three scales of the CBCL were examined to assess the effectiveness of the two therapeutic approaches pre- to post-treatment. Significant pre- and post-treatment differences were found for behavioural family therapy on the Internalizing, Externalizing, and Sum T scales and for brief family therapy on the Internalizing and Sum T scales. Sum T scales represent the sum of scores across all sub-scales of the CBCL. Neither treatment was found to be more effective than the other.     

Youth characteristics associated with behavioral and mental health problems during the transition to residential treatment centers: the Odyssey Project population

This study aimed to determine what youth characteristics were associated with emotional and behavioral problems exhibited within the first three months of placement in residential treatment centers (RTCs) in a sample of youth from 20 agencies in 13 states. Two primary research questions were addressed: 1) What characteristics were associated with behavior during the transition to care? 2) Were the characteristics associated with behavior during the transition the same for boys and girls? Data were drawn from the Time 1 phase of the longitudinal national Odyssey Project dataset developed by the Child Welfare League of America. Measures included an extensive child and family characteristics (CFC) form and the Achenbach Child Behavior Checklist (CBCL). The results revealed significant gender-specific patterns of associations between youth characteristics and behavior exhibited during the transition to RTC placement. Notably, a sexual abuse history was associated with Externalizing for girls and Internalizing for boys and entering on psychotropic medication was associated with Internalizing for girls and boys and Externalizing for boys only. Results suggest many avenues for refining practice.     

The Child Dissociative Checklist

This paper reports on the use of a screening instrument for dissociative behaviors in two separate, but related-studies. Study 1 examined the concurrent validity of the Child Dissociative Checklist (CDC) in a sample of children and adolescents for which no efforts were made to separate youngsters by history of abuse. Concurrent validity of the CDC was studied in relation to an accepted measure of general behavior problems, the Child Behavior Checklist (CBCL). Results indicate significant, positive correlations between CDC raw scores and CBCL Externalizing (EXT), Internalizing (INT), and Total (TOT) T scores for males (p < .005). For females, the CDC correlated significantly and positively with CBCL INT (p < .05) and TOT T (p < .01) scores, but not with the EXT T score. Significant and positive correlations for males were obtained between all specific CBCL factors and the CDC (all p < .005). For females. CDC scores correlated significantly with specific internalizing factors purported to measure depression, immaturity, and anxiety (all p < .05). These findings are discussed in relation to issues of misdiagnosis and comorbidity. Study 2 found that parent-completed CDC scores differentiate between sexually abused inpatient children and those with no history of sexual abuse categorized into groups based on their responses to the Traumatic Antecedents Scale. Inpatient staff completed CDC ratings failed to differentiate between groups. Moreover, there was a negative, though nonsignificant, correlation between staff and parent CDC scores.     

Competencies and problem behaviors of children in family foster care: variations by kinship placement status and race

Formal kinship foster care is an increasingly common form of out-of-home placement, and several important distinctions between kinship care and non-relative foster care have been identified. The present study evaluated the behavior of kinship foster children in comparison to non-relative foster children and children in the general population. A geographically and ethnically diverse sample of foster children (N=240) was assessed for competence and problem behaviors using the Child Behavior Checklist (CBCL: Achenbach, 1991). Kinship foster children closely resembled children in the general population but differed significantly from their counterparts in non-relative foster care, who consistently scored lower on competence and higher on problem behaviors. Substantial proportions of non-relative foster children were in the clinical range on most CBCL measures, but kinship foster children were no more likely than children from the general population to score above clinical cut-offs. Differences between kinship and non-kinship foster children became less dramatic after accounting for child race and gender, which were both associated with kinship status. Child race had a strong main effect for almost all types of problem behaviors, with children of color showing significantly less problematic behavior. Discussion of these results centers on potential explanations for the observed variations in child behavior by kinship status and race.     

The Association of Sexual Behavior with Externalizing Behaviors in a Community Sample of Prepubertal Children

Abstract

On the basis of the problem-behavior theory for adolescence, we hypothesized that already during childhood sexual behavior is associated with (non-sexual) externalizing behaviors and tested the hypothesis in a community sample. In the context of a postal questionnaire survey of 6-10 year old children, the parents of 349 girls and 326 boys completed the Child Behavior Checklist (CBCL). The CBCL Sex Problems scale did not differ between genders, ethnic groups, or age groups. For both girls and boys, the scores on the Sex Problems scale correlated significantly but modestly (maximum r = 0.35) with all other CBCL scales; only in boys did the correlations with externalizing behaviors exceed those with other scales. We conclude that children from a community sample who show sexual behavior as defined by the CBCL tend to be the ones with increased behavioral/emotional problems in general, with only modest specificity in symptomatology.     

Safe Havens to Abandon Babies,Part I

Abstract

The occurrence of symptoms of Attention Deficit, Hyperactivity Disorder (ADHD) in eighty children adopted from Romania was studied. Their average age on arrival was 2.10 and at the start of this study 8 years. The 72 parent-couples (response 83%) were extensively interviewed and filled out the Dutch ADHD-questionnaire and the Child Behavior Checklist (CBCL). Twelve of the 80 participant children (15%, eleven boys and one girl) clearly showed symptoms of ADHD. In addition they exhibited more Externalizing Behavior (CBCL) than the remaining 68 children (75% vs. 25%). These 12 children more often attended special education than the others (67% vs. 25%). The ADHD children also showed less recovery over time. Ten of the twelve ADHD children also showed comorbidity, i.e., symptoms of posttraumatic stress reaction, post institutionalized autism and other behavioral disorders. The ADHD children needed more professional care than the remaining 68 children. Their parents, however, judged the received care more negatively than the Other parents.     

Foster parent and teacher assessments of youth in kinship and non-kinship foster care placements: are behaviors perceived differently across settings?

With a growing number of children living in kinship foster care, it is important to understand how youths are faring in kinship care compared to youths in non-kinship care. In the present study, we first evaluate teacher ratings of problem behaviors exhibited in school by youths in kinship and non-kinship foster care. We then examine whether correspondences between parent and teacher ratings of problem behaviors across home and school settings differ by kinship status. The youths in the study represent an ethnically diverse sample (N = 185), with significantly more children of color in kinship placements. Across the majority of problem behavior scales on the Teacher's Report Form (TRF: Achenbach, 1991), teacher perceptions of youth behavior did not differ significantly according to kinship or non-kinship care placement. Furthermore, the youths in this study had elevated scores relative to general population norms on only a few TRF problem behavior scales. A sub-sample (N = 122) with foster parent assessments on the Child Behavior Checklist (CBCL: Achenbach, 1991) permitted comparison of perceptions of youth behavior across the home and school settings for youths in kinship and non-kinship placements. Correlations between the TRF and CBCL composite scale scores (internalizing, externalizing, and total problem behaviors) indicated slightly higher agreement between teacher and foster parent ratings for kinship placements. The non-kinship foster parents reported higher levels of problem behavior at home relative to school. The paper interprets these results and suggests implications for practice and future research directions.     

Parent and Peer Attachment in Minority Males at High Risk for Delinquency

Juvenile delinquency and high risk behaviors have been linked to disturbances in attachment. The present study examined parent and peer attachment in 67 African American males and 97 Latinos (ages 12–17, M = 14.7 ± 1.3) attending an alternative school. The Inventory of Parent and Peer Attachment was used to identify 3 attachment style groups: “Isolated,” “Disconnected,” and “Connected.” Controlling for age, attachment group membership predicted differences in delinquent behaviors, as did ethnicity. Further, on the Youth Self-Report of the Child Behavior Checklist, attachment group membership predicted differences in both the Internalizing and Externalizing Scales. Implications for interventions with each identified attachment group are discussed.     

Children's Psychological Response to Parental Victimization

Abstract

This study found that African American children, 6 through 12 years of age, whose parents had been victims of community violence (i.e., gunshot or stabbing) experienced distress symptoms differently, depending on their gender. In the authors' previous work (Dulmus & Wodarski, 2000), children, age 6-12, whose parents were victims of community violence (e.g., gunshot, stabbing), and whose victimization the children did not witness, were found to be experiencing distress symptoms related to their parents' victimization. The purpose of this current study was to do further analysis to examine children's psychological response to parental victimization by gender. Results indicated that all children in the study were experiencing symptoms in the borderline clinical range as measured by the total score on the Child Behavior Checklist (CBCL), with females having a mean score of 39.5 and males having a mean score of 38. The differences that were found by gender were in children's expression of symptoms; with females experiencing more internalizing symptoms (i.e., withdrawn, somatic complaints, anxiety, depression) and males experiencing more externalizing symptoms (i.e., aggression, delinquent behaviors). Such results support feminist theory, which suggests that girls and boys respond differently to stimuli because of gender differences related to socialization. Such distinctions may be clinically useful when choosing approaches to behavioral interventions.     

Children of Adolescent Mothers: Cognitive and Behavioral Status at Age Six

The cognitive and behavioral status at age six years of 185 children of adolescent mothers (60.5% boys) were assessed using the mother (CBCL) and teacher (TRF) report forms of the Child Behavior Checklist and the Bracken Basic Concepts Scale. There was evidence for impairment in all areas of functioning. More than half of the sample exceeded the borderline clinical cutoff (T = 60) on either the CBCL or TRF Total Problem score, and nearly half the sample had Bracken scores that were more than 1 SD below the normative mean. Only 26.9% of the children were in the normal range on all three measures. These results are discussed in terms of implications for social work practice with children and adolescent mother families.     

Family Communication as a Mediator of Child Adjustment to Divorce

Abstract

Reduced family conflict, consistency in roles and parenting, and limited negative life changes seem to be particularly important variables in promoting children's adjustment to divorce.

The impact of family functioning on child adjustment was investigated in a sample of 22 recently separated or divorced families with a total of 32 children. A series of multiple regression analyses using factors on the Family Assessment Device to predict Child Behavior Checklist scores indicated that family functioning is a significant predictor of children's Externalizing behavior problems. The Communication factor accounted for a significant portion of unique variance in the externalizing scores that was unaccounted for by the other factors. When separated parents can communicate with each other to co-parent their children, as well as communicate affective limit-setting messages to their children, the children exhibit less behavioral problems.     

A comparison of two programmes for victims of child sexual abuse: a treatment outcome study

This study aimed to evaluate the comparative effectiveness of individual therapy and combined individual and group therapy in the treatment of the psychological sequelae of child sexual abuse. The Child Behaviour Checklist (CBCL), the Youth Self Report form (YSR), the Children's Depression Inventory (CDI) and the Trauma Symptom Checklist for Children (TSCC) were administered before treatment and 6 months later to a group of 20 young people who participated in individual therapy (IT) programmes and to a group of 18 young people who participated in programmes that involved combined individual and group therapy (IGT). For both types of programmes, statistically significant improvement occurred on the following scales: the total problems, internalizing problems, externalizing problems, withdrawn, somatic complaints, anxious/depressed, social problems, attention problems and aggressive behaviour problems CBCL scales; the total depression, interpersonal problems and anhedonia CDI scales; and the depression and anger TSCC scales. The only scale for which one therapy programme led to greater improvement than another was the CDI ineffectiveness scale. The IGT programme led to a reduction in the mean CDI ineffectiveness score, whereas a slight increase in the mean ineffectiveness score occurred in the IT group. There were no significant differences in the rates of clinically significant improvement associated with the two treatments and no major differences between cases who improved and those that did not improve over the course of therapy. From this study, it may be concluded that after 6 months, individual therapy and combined individual and group therapy were equally effective in the treatment of the psychological sequelae of child sexual abuse. Copyright © 2002 John Wiley & Sons, Ltd.     

Assessing behavior in children aged 12–24 months using the Strengths and Difficulties Questionnaire

Behavioral and emotional problems in infants and toddlers are common, often persist and put children at risk of later mental health problems. Reliable, efficient, and sensitive tools are needed to identify young children who may benefit from further assessment and support. The Strengths and Difficulties Questionnaire (SDQ), offers a brief, convenient means of screening for early problems, however, it lacks psychometric validation in infants. The aim of this study was to assess the validity and reliability of the SDQ in children aged 12–24 months. Ninety-three participants, with children aged 12–24 months, completed the SDQ and Child Behavior Checklist (CBCL) online. Concurrent validity of the SDQ was assessed through comparison with the CBCL. The results demonstrated that key subscales of the SDQ and CBCL were significantly correlated (r range= −.19 to –.57). Key SDQ subscales showed moderate reliability (Cronbach's alpha range = .38–.79, mean inter-item correlation range = .06–.43). The SDQ shows promising reliability and validity as a measure for rating the behavior of 12–24-months-old children, particularly for externalizing symptoms. Further research is needed to assess its predictive utility.     

Behavioral problems of special needs adopted children

Parents of 757 special needs adoptees completed the behavior problems section of the Achenbach Child Behavior Checklist. Significant behavioral problems were not indicated for those children aged 4–5 at the time of the study. For children aged 6 to 16, behavioral problem scores were elevated on the two major CBC scales, externalizing (aggressive, acting-out behavior) and internalizing (withdrawn, inhibited behavior). The degree of elevation was greater for externalizing. Elevated scores were also observed on the total behavioral problems scale and, in particular, on hyperactivity sub-scales.     

Mental health and behavioral problems of youth in the child welfare system: residential treatment centers compared to therapeutic foster care in the Odyssey Project population

This is the first multisite, prospective study of behavioral and mental health disorders of youth in residential treatment centers (RTC) and therapeutic foster care (TFC), and the first study to compare the two. This study addressed two questions in a sample of 22 agencies in 13 states: (1) how prevalent were emotional and behavioral disorders in the youth admitted to RTCs and TFC?, and (2) were the youth in RTCs significantly more likely to be disturbed than youth served in TFCs? Data were drawn from the Time 1 phase of the longitudinal national "Odyssey Project" developed by the Child Welfare League of America (1995). Measures included an extensive child and family characteristics form (CFC) and the Child Behavior Checklist (CBCL). The results revealed extremely high levels of behavioral and mental health disorders in the sample as a whole, well above the norms for a non-child welfare population. The prevalence of disorder in the RTC population was substantially greater than in the TFC population.     

Friendship in children with internalizing and externalizing problems: A preliminary investigation with the Pictorial Assessment of Interpersonal Relationships

This study examined the relationship between friendship representation and internalizing and externalizing problems in school-aged children. One hundred Caucasian 6–7 year-old children (50 males and 50 females) and their mothers took part in the study. The Draw-a-Man Test, the Pictorial Assessment of Interpersonal Relationships, and the Child Behavior Checklist (CBCL/6-18) were used. Children with internalizing problems, externalizing problems, comorbid internalizing and externalizing problems, and a control group were compared on their pictorial representations of friendship. Results showed that children with externalizing problems included more pictorial indices of each friend's autonomy and a larger imbalance of importance between them; children with internalizing problems drew themselves as less similar to their friends. In conclusion, children's pictorial representation allows exploring some aspects of their tacit knowledge about the relationship with a best friend, which is not easily expressed verbally by young children. Finally, the implications of these findings for theoretical and empirical research development on friendship are discussed.     

A Shelter-Based Stress-Reduction Group Intervention Targeting Self-Esteem, Social Competence, and Behavior Problems Among Homeless Children

It has been estimated that families with children now account for 40% of the population who become homeless. Given the consistency of research showing the potentially damaging effects of homelessness as a stressor upon the social and emotional development of children, the question of importance is how to best intervene to reduce the likelihood or severity of such possible negative consequences. The approach taken here involved the development of a Shelter-Based Stress-Reduction Group Intervention Targeting Self-Esteem and Behavior Problems Among Homeless Children.Data were collected on 52 elementary-school–age children from family-shelter facilities in Central Florida. The child's level of psychosocial functioning was assessed using the Coopersmith Self-Esteem Inventory (CSEI) and Achenbach's Child Behavior Checklist (CBCL). Although the repeated measures ANOVA techniques applied to those subjects were nonsigni-ficant, the relatively small sample size in study conditions led to consideration of the magnitude of effect sizes obtained in treatment and comparison groups. The changes in the intervention group's mean scores on key psychosocial outcome variables of interest were consistent with hypotheses, providing suggestive evidence of the potential utility of stress management training.     

A Shelter-Based Stress-Reduction Group Intervention Targeting Self-Esteem,Social Competence,and Behavior Problems Among Homeless Children1

It has been estimated that families with children now account for 40% of the population who become homeless. Given the consistency of research showing the potentially damaging effects of homelessness as a stressor upon the social and emotional development of children, the question of importance is how to best intervene to reduce the likelihood or severity of such possible negative consequences. The approach taken here involved the development of a Shelter-Based Stress-Reduction Group Intervention Targeting Self-Esteem and Behavior Problems Among Homeless Children. Data were collected on 52 elementary-schoolage children from family-shelter facilities in Central Florida. The child’s level of psychosocial functioning was assessed using the Coopersmith Self-Esteem Inventory (CSEI) and Achenbach’s Child Behavior Checklist (CBCL). Although the repeated measures ANOVA techniques applied to those subjects were nonsignificant, the relatively small sample size in study conditions led to consideration of the magnitude of effect sizes obtained in treatment and comparison groups. The changes in the intervention group’s mean scores on key psychosocial outcome variables of interest were consistent with hypotheses, providing suggestive evidence of the potential utility of stress management training.     

Social Work Assessment of Children with Oppositional Defiant Disorder

Abstract

A review of the empirical literature was conducted concerning the use of the Child Behavior Checklist(CBCL) in the assessment and treatment of children meeting the DSM-IV criteria for Oppositional Defiant Disorder. Even though the information is more limited on the CBCL in regards to ODD, compared to youth with Conduct Disorder, it is evident that this scale is a practical rapid assessment instrument with clinical, administrative, research, and program evaluation uses. Social workers serving children meeting the criteria for ODD, and those engaged in research and evaluation with such children, are encouraged to consider using the CBCL as a part of a comprehensive social work assessment package.