Family Groups for Urban Youth With Disruptive Behavior

NCT02715414 | Completed

• 1 other identifier: R01MH106771
• Study Type: interventional
• Target: 2,956
• Locations: 1 country
• Sites: 1

Brief Summary

A multiple family group (MFG) is a family-centered, group delivered, evidence-informed, manualized intervention that targets the most common reason for referral to publicly funded clinics: youth oppositional defiant and conduct disorders. This study will employ a mixed methods Type II effectiveness-implementation hybrid research design.In collaboration with the New York State Office of Mental Health (OMH), this longitudinal study will be conducted across the New York City (NYC) OMH licensed child behavioral health clinic system (n=134). The investigators will use mixed methods, and involve 268 providers and 2,688 adult caregivers of youth (7 to 11 years). The following Specific Aims guide this study: To examine 1) short-term and longitudinal impact of MFGs on urban youth with Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) (replication); 2) family-level mediators (e.g. parenting, family process) of child outcomes; 3) clinic (readiness to adopt an innovation, leadership support and climate) and provider level moderators (preparedness, motivation and fidelity) of MFG implementation and integration and; 4) the impact of Clinic Implementation Teams (CIT) on clinic and provider level moderators of MFG implementation and integration. In this Randomized Controlled Trial, clinics will be stratified by borough (Manhattan, Queens, Bronx, Brooklyn, Staten Island) and randomly assigned within borough to 3 study conditions: 1) MFG+CITs; 2) MFG (with standard research training and consultation) or; 3) Standard Care. Data will be collected baseline, 8 and 16 weeks and 6 mo. follow-up) in Phase 1 (focus on implementation) and Phase II (integration).

Conditions

Mental Disorders

Outcome Measures

Primary Outcomes (1)

• Change in Child Behavior and Impairment

  Child behavior and impairment is assessed via the Disruptive Behavior Disorders Rating Scale.

  Baseline, treatment mid-point (8 weeks), posttest (16 weeks), and six month followup (post-treatment)

Other Outcomes (9)

• Change in Family processes (e.g., rules, responsibilities, relationships, respectful communication)

  Three times points: Baseline, treatment mid-point (8 weeks), posttest (16 weeks)

• Change in Parent stress

  Three times points: Baseline, treatment mid-point (8 weeks), posttest (16 weeks)

• Change in Clinic readiness and leadership

  Baseline and posttest (16 weeks)

Study Arms (3)

Multiple Family Group (MFG)

ACTIVE COMPARATOR

A multiple family group (MFG) is a 12-week, family-centered, group delivered intervention consists of six to eight families (caregiver/child dyads). Groups meet for approximately two hours per week, and sessions focus on targeting family-level factors that are associated with child problem behaviors. Specifically, eight of the 12 sessions are devoted to establishing rules (family organization, consistent discipline), responsibilities (inter-connectedness, expectancies), relationships (family warmth, within family support), respectful communication (family communication and conflict). An additional four sessions are focused on factors that impact the ability of families to incorporate new behaviors (family stress and social support).

Behavioral: MFG

MFG + Clinic Implementation Team

EXPERIMENTAL

This condition consists of service providers, directors, and clinic staff who will create site-specific plans to enhance uptake and implementation of MFG. CITs address potential barriers to implementation and adjust the format and structure of MFG as needed in order to be implemented as part of clinic care.

Behavioral: Multiple Family Group + Clinic Implementation Team

Standard Care

NO INTERVENTION

Standard Care consists of services including outpatient individual and family therapy, which are offered as part of clinic care.

Interventions

Multiple Family Group + Clinic Implementation Team BEHAVIORAL

Clinic Implementation Teams (CIT) include providers at the clinic that aim to enhance uptake and implementation of MFG through modifications of MFG (e.g., format, length of sessions), but no modification to content will occur.

MFG + Clinic Implementation Team

MFG BEHAVIORAL

MFG is a 12-week group involving 6-8 families of children with problem behaviors. MFG aims to reduce family-level factors that are associated with the onset and perpetuation of problem behaviors. Eight of the 12 sessions are devoted to rules, responsibilities, respectful communication and relationships. Four additional sessions target family stress and social support.

Also known as: Multiple Family Group

Multiple Family Group (MFG)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• provider willing to participate
• an adult caregiver of a child between 7 and 11 years of age with a diagnosis of Oppositional Defiant Disorder or Conduct Disorder

You may not qualify if:

• None

Sponsors & Collaborators

• NYU Silver School of Social Work: lead

Study Sites (1)

McSilver Institute for Poverty Policy and Research - New York University Silver School of Social Work

New York, New York, 10003, United States

Location

Related Publications (5)

• Acri, M., Gopalan, G., Chacko, A., & McKay, M. (in press). Engaging families into treatment for child behavior disorders: A synthesis of the literature. In J. Lochman & W. Mathys (Eds.), Wiley Handbook of Disruptive and Impulse-Control Disorders.

  BACKGROUND

• Hamovitch E, Acri M, Bornheimer LA. Who is accessing family mental health programs? Demographic differences before and after system reform. Child Youth Serv Rev. 2018 Jan;85:239-244. doi: 10.1016/j.childyouth.2017.12.027. Epub 2017 Dec 24.

  PMID: 29736093 BACKGROUND

• Bornheimer, L. A., Acri, M., Parchment, T. ( in press). Attitudes towards and use of Evidence-Based Practice among providers of child mental health services in New York City. Research on Social Work Practice.

  BACKGROUND

• Acri MC, Bornheimer LA, Jessell L, Chomancuzuk AH, Adler JG, Gopalan G, McKay MM. The intersection of extreme poverty and familial mental health in the United States. Soc Work Ment Health. 2017;15(6):677-689. doi: 10.1080/15332985.2017.1319893. Epub 2017 Jun 29.

  PMID: 29618956 RESULT

• Acri M, Hamovitch E, Mini M, Garay E, Connolly C, McKay M. Testing the 4Rs and 2Ss Multiple Family Group intervention: study protocol for a randomized controlled trial. Trials. 2017 Dec 4;18(1):588. doi: 10.1186/s13063-017-2331-7.

  PMID: 29202867 DERIVED

MeSH Terms

Conditions

Mental Disorders

Interventions

Psychotherapy, Group

Intervention Hierarchy (Ancestors)

Socioenvironmental Therapy; Psychotherapy; Behavioral Disciplines and Activities

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: McSilver Professor of Poverty Studies, Director, McSilver Institute for Poverty Policy and Research

Study Record Dates

• First Submitted: March 3, 2016
• First Posted: March 22, 2016
• Study Start: June 1, 2015
• Primary Completion: August 1, 2018
• Study Completion: December 1, 2019
• Last Updated: March 2, 2020

Record last verified: 2020-02

Data Sharing

• IPD Sharing: Will share

Locations

US (1)