Is there evidence for the effectiveness of the approach?
The approach described in the book,
Treating Explosive Kids: The Collaborative Problem Solving Approach has demonstrated remarkable effectiveness in a number of different settings, and there are several studies being conducted currently that will hopefully add to the evidence base. Below you'll find information and links to various published research listed by setting in which it was conducted.
Outpatient Therapy
The first empirical study on the approach was a randomized, controlled clinical trial conducted in the Department of Psychiatry at Massachusetts General Hospital. This study compared our approach to a commonly used and empirically supported treatment called Parent Management Training. You can download a pdf version of the results published in the Journal of Consulting and Clinical Psychology by
clicking here. A large-scale replication study of the approach in outpatient treatment is currently underway at Virginia Tech through a R01 grantfrom NIMH.
Inpatient Psychiatry Units
The next empirical study on the approach examined changes on a child inpatient psychiatry unit that implemented the model. The Child Assessment Unit at Cambridge City Hospital achieved amazing results as you can see by
downloading a pdf version of the published results.
A third study was then conducted by independent investigators interested in determining whether these results could be replicated at Yale - New Haven's Childrens Hospital. The results of this five-year prospective study were published recently in Psychiatric Services and can be found
here.
An additional article was published that should be of great interest to those working in residential treatment facilities and inpatient psychiatry units - as well as schools.The article provides a critical review of the theory behind and use of motivational systems in such settings.It then goes on to describe the process of implementing our approach as a child-centered alternative to point and level systems at the Yale Child Study Center. The process of implementation was conducted with extensive training and consultation from Dr. Ablon, and many of the details of the culture change that took place and the critical ingredients that made it successful are detailed in the article which can be downloaded here. This article is a great addition to the literature that should be a huge help to others interested in implementing the model in their programs.
Residential Treatment Programs
More recently, our Canadian colleagues submitted a final report to the Centre of Excellence in Children's Mental Health at the Children's Hospital of Eastern Ontario that documents the effectiveness of the approach in a residential setting. The report is extremely exciting not only because it is the first systematic study to demonstrate effectiveness in residential treatment, but also because it documented improvement in child functioning across several areas including significant gains in the development of specific social skills through implementation of the approach. This is the first such study to validate the skills training aspect of the approach empirically. Other exciting findings: children and adolescents in the study showed enhanced participation in their communities after treatment and many gains were maintained at six-month follow up including a further reduction in behavioral outbursts. Click here to download a copy of this impressive report.
Parenting Groups
A new area of research on the approach focuses on parenting group interventions. Our colleagues from Toronto published a study recently attesting to the effectiveness of a parenting group intervention based on the model and evaluated its feasibility and efficacy. Significant improvements in child behavior were reported by both mothers and fathers at the end of the intervention and follow-up. There were also significant reductions in mothers’ stress. Click here to download and read the complete report.
Schools
The most recent published research comes from two of Think:Kids certified trainers, Averi Schaubman and Erica Stetson, who work in the Cherry Creek Schools in Colorado. They piloted using the approach in an alternative middle school setting and showed significant reductions in teacher stress and office referrals for disciplinary reasons. Click here to read the study published in the School Social Work Journal. We're excited to see published data emerging from school settings specifically!
Symptom Improvement vs. Functioning
Another article was just recently published which highlighted our approach as one of the few of over 750 different treatment protocols targeting child mental health problems that demonstrated improvements in functioning as opposed to simply symptom reduction. While we'd like to think that these exciting results are due to our emphasis on skills training rather than simply symptom reduction, future research is needed to test this hypothesis. Click here to download this article.
Due to data like these, Think:Kids is now listed on the California Evidence-Based Clearinghouse for Child Welfare. Status as evidence-based practice has been achieved in places like the state of Oregon where the Division of Addictions and Mental Health is helping sponsor training throughout their children's mental health system with our help. We are thrilled that training in our approach has recently been written into the administrative rules in Oregon due to the evidence base. Impressive results have also been documented in many other systems such as adolescent inpatient psychiatric units, residential and day treatment programs, juvenile detention facilities and schools. Data from these settings have been collected and with your help we hope they will be published soon. If you are interested in studying your use of the approach or already have data to share from your setting, please email us. In the meantime, you can also click here to download a current list of references of publications related to the work.
Click here to watch video of Dr. Ablon describing results in restrictive facilities that have implemented the model.