Describing usual care practice with parents of children with conduct problems

Aim: The goals of this study are to characterize the strategies used with caregivers of children with disruptive behavior problems in community-based clinics and to identify child and therapist characteristics associated with greater use of strategies common across EBP for this group of children Methods: Participants included a representative and diverse sample of children and therapists (see A. Garland's abstract above for sample characteristics and methods). A random selection of 710 sessions in which caregivers were present for at least part of the session were coded to described the types of psychotherapeutic strategies observed. Results: Caregivers were present in at least part of 72% of the child sessions. The most frequently addressed content area with caregivers was Addressing Child's External Care (present in >50% of sessions). The most frequently observed treatment techniques with caregivers included, Assessing Problems and Events, Psychoeducation, and Establishing and Reviewing Goals. Active strategies such as Modeling, Role-play/ Practice, and Assigning/ Reviewing Homework were observed relatively infrequently (<25% sessions). The average intensity ratings of these strategies ranged from low to moderate. Individual child, caregiver, and therapist characteristics were significantly associated with more intensive use of certain strategies common in EBPs in mulit-level modeling analyses (e.g., child demographic, clinical characteristics; caregiver demographic and strain; therapist background). Discussion: While therapists are using some strategies consistent with those common in EBP, they are used with relatively low intensity and other EBP strategies are being used infrequently. These descriptive data provide an important foundation for integrating EBP strategies into usual care.