| 1. |
- Andrée Löfholm, Cecilia, et al.
(författare)
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The Swedish Implementation of Multisystemic Therapy for Adolescents: Does Treatment Experience Predict Treatment Adherence?
- 2014
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Ingår i: Journal of Clinical Child and Adolescent Psychology. - : Informa UK Limited. - 1537-4424 .- 1537-4416. ; 43:4, s. 643-655
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Tidskriftsartikel (refereegranskat)abstract
- Treatment effects may not be observed if an empirically supported intervention is not administered with treatment adherence. This retrospective study investigated how therapists' adherence to Multisystemic therapy (MST) varied during a 6-year period in Sweden. Adherence was measured using the Therapist Adherence Measure, which was provided by caregivers. The associations between treatment adherence and therapist-reported posttreatment youth outcomes were also assessed. Retrospective adherence data were obtained for 973 families with youths between 12 and 17 years old who received MST from 68 therapists divided into 10 teams. Implementation of MST occurred in 2 waves between March 2003 and August 2009. Multilevel structural equation modelling was used to evaluate family-and cohort-level predictors and outcomes of treatment adherence. The results confirm previous research: Treatment adherence predicts MST treatment outcomes. With respect to the relationship between MST treatment experience and MST treatment adherence, the analysis showed mixed results. An increase in years that a team had been active predicted an increase in therapist adherence to MST. Therapists from the 2nd implementation wave had higher therapist adherence rates than therapists from the 1st implementation wave. Nevertheless, a therapists' experience with MST did not predict MST treatment adherence. The results suggest that the found links among treatment experience, treatment adherence, and treatment outcomes provide support for the hypothesis that the collective experience of the team members promotes treatment adherence. However, results are mixed and further research is needed.
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| 2. |
- Andrée Löfholm, Cecilia, et al.
(författare)
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Utvärdering av Multisystemisk terapi för ungdomar med allvarliga beteendeproblem : resultat efter fem år
- 2014
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Multisystemisk terapi (MST) är en strukturerad familje- och närmiljöbaserad öppenvårdsbehandling inom socialtjänsten för ungdomar med beteendeproblem. Det här är den tredje och sista delstudien i en utvärdering som undersökt hur MST har fungerat jämfört med socialtjänstens traditionella insatser. Undersökningsgruppen består av 156 ungdomar som genom randomisering fördelades till MST eller traditionell behandling. I den här rapporten undersöks ungdomarnas situation under en femårsperiod med hjälp av information från olika register.Resultaten visar att:Ungdomarna har fått ett stort antal insatser från socialtjänsten under femårsperioden, både inom öppenvård och i form av placeringar utom hemmet. Två av fem (39%) ungdomar har varit aktuella för en eller flera insatser under mer än två år sammantaget. Nästan hälften (47%) har vid något tillfälle varit placerade utom hemmet.Två tredjedelar (69%) av ungdomarna har dömts för ett eller flera brott under uppföljningsperioden. Vanligast var tillgreppsbrott, personbrott och narkotikabrott. Andelen ungdomar som lagfördes för brott varierade inte nämnvärt under de fem åren.Nästan fyra av tio ungdomar (38%) hade antingen fått vård inom psykiatrins öppen- eller slutenvård (26%) eller vård inom hälso- och sjukvården för missbruksproblematik (17%). Var femte ungdom (19%) har varit i slutenvård för missbruk och/eller psykiatri.Resultaten visar att MST och traditionella insatser var lika effektiva för den undersökta gruppen ungdomar.MST-gruppens ungdomar har i genomsnitt kostat samhället 112 000 mer än ungdomar som fått traditionella insatser. Totalt har de 156 ungdomarna lågt räknat kostat 154,7 miljoner under de fem åren.En av bakgrundsfaktorerna, kön, kan ha haft en differentierande effekt på behandlingen; flickor i MST-gruppen var mindre kriminellt belastade än de i den traditionella gruppen, medan det omvända förhållandet gällde för pojkarna. Detta resultat är dock mindre tillförlitligt och behöver följas upp i fortsatt forskning.Resultatens betydelse för socialtjänstens fortsatta utvecklingsarbete diskuteras avslutningsvis.
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| 3. |
- Ferrer-Wreder, Laura, et al.
(författare)
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Tinkering with Perfection : Theory Development in the Intervention Cultural Adaptation Field
- 2012
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Ingår i: Child and Youth Care Forum. - : Springer Science and Business Media LLC. - 1053-1890 .- 1573-3319. ; 41:2, s. 149-171
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Tidskriftsartikel (refereegranskat)abstract
- Background Testing evidence-based interventions (EBIs) outside of their home countryhas become increasingly commonplace. There is a need for theoretically guided researchon how to best create and test the effects of culturally adapted interventions.Objective To illustrate how the field might raise the scientific and practical value offuture effectiveness and dissemination trials of culturally adapted interventions, as well asto provide support for theoretically informed research on this subject to take greater root.Methods Nine theories that offer guidance on how to adapt existing EBIs for a newcultural group were summarized and evaluated.Results Commonalities among the selected theories included a focus on the need forcollaboration as part of the adaptation process and shared emphasis on taking systematicsteps to select an intervention to adapt, as well as calls for adaptations to be guided byspecific types of empirical studies. Among the theories, variability existed in terms of whatconstituted an adaptation.Conclusions As EBIs go global, intervention adaptation promises to be the subject ofsubstantial future scholarly attention. There is a need to develop systematic evidence-basedmethods that allow for some degree of adaptation, while still bringing about EBIs’ desiredbenefits.
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| 4. |
- Ferrer-Wreder, Laura, et al.
(författare)
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Utvärdering av importerade interventioner
- 2012
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Ingår i: Att göra effektutvärderingar. - Stockholm : Gothia Förlag AB. - 9789172058385 ; , s. 205-222
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Bokinformation: Varje år berörs hundratusentals personer av psykosociala och pedagogiska interventioner. Det handlar exempelvis om behandling av missbruk, insatser för utsatta barn och läsundervisning i grundskolan. Endast undantagsvis har dessa interventioner utvärderats, vilket innebär att vi inte vet vilken effekt de har eller om de rentav kan skada. I antologin Att göra effektutvärderingar beskrivs hur man genomför effektutvärderingar, som ger kunskap om hur interventioner fungerar. Boken ger detaljerad och praktisk vägledning som är till nytta för alla som är intresserade av att lära sig mer om effektutvärderingar – både forskarstuderande och forskare som redan ansvarat för effektutvärderingar. Ämnen som tas upp är bland annat forskningsetik, studiedesign, mätinstrument, urval och rekrytering av undersökningspersoner, datainsamling, ekonomiska analyser, dataanalys och tolkning samt rapportskrivning. Bokens författare har lång erfarenhet inom området och representerar olika discipliner såsom psykologi, folkhälsovetenskap, socialt arbete, pedagogik, statistik, epidemiologi, sociologi, evolutionsbiologi, medicinsk vetenskap och datavetenskap. Redaktör för boken är Knut Sundell, docent i psykologi och socialråd på Socialstyrelsen, som har lång erfarenhet av att utvärdera interventioner inom förskola, skola och socialtjänst.
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| 5. |
- Forster, Martin, et al.
(författare)
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A randomized controlled trial of a standardized behavior management intervention for students with externalizing behavior
- 2012
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Ingår i: Journal of Emotional and Behavioral Disorders. - : SAGE Publications. - 1063-4266 .- 1538-4799. ; 20:3, s. 169-183
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Tidskriftsartikel (refereegranskat)abstract
- This study reports the results from a Swedish randomized controlled trial of a standardized behavior management intervention. The intervention targeted students with externalizing behavior in a regular education setting. First- and second-grade students (N = 100) from 38 schools were randomly assigned to either the intervention or an active comparison group. Observer, teacher, and peer ratings were collected at pretest, posttest (6 months later), and follow-up (14 months after pretest). Significant intervention effects were found on student externalizing behavior and teacher behavior management at both posttest and follow-up. The intervention effect on student externalizing behavior was mediated by change in teacher behavior. Moderating effects of demographic and classroom variables were explored, as well as the social validity of the intervention. The results are discussed in relation to cost-effectiveness and feasibility of behavioral interventions in typical school settings.
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| 6. |
- Forster, Martin, et al.
(författare)
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Clinical Significance of Parent Training for Children with Conduct Problems
- 2012
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Ingår i: International Journal of Conflict and Violence. - 1864-1385. ; 6:2, s. 187-200
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Tidskriftsartikel (refereegranskat)abstract
- While there is a strong evidence base for behavioral parent training in the treatment ofchild conduct problems, the clinical impact is less well known. Meta-analyses report effect sizes in the medium range, but the common practice of reporting "small," "medium," and "large" effects can be misleading and difficult to understand for practitioners and clients. There is a need for more research addressing the clinical significance of behavioral parent training, which would help to bridge the gap between research and practice. In the first part of this report, a reanalysis in termsof clinical significance of two outcome studies published by the authors was conducted. In the second part, the results from the first part were compared to six outcome studies published by other authors. The median number needed to treat across studies was five, which means that forevery five treated children, one shows reliable change and moves from the dysfunctional to the functional population.
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| 7. |
- Forster, Martin, 1971-
(författare)
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When Cheap is Good : Cost-Effective Parent and Teacher Interventions for Children with Externalizing Behavior Problems
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- There is strong empirical support for behavioral parent training (BPT) as an intervention for children with externalizing behavior problems (EBP). However, there is a lack of studies that have investigated the effectiveness of BPT in routine care. Furthermore, most families in need of service do not gain access to it. Another issue of concern is that a sizable portion of children who take part in BPT does not show clinical significant improvement. With regard to behavioral teacher training (BTT) for students with EBP, there is a paucity of intervention trials using randomized design. The training procedures have rarely been standardized, which have resulted in interventions that are dependent upon heavy involvement of external consultants. To improve the accessibility to service for students with EBP, intervention models that are feasible for typical school personnel need to be developed. Study I investigated the effects of BPT in routine care. The participants were randomized to BPT with full practitioner support (BPT-P), self-administered BPT with minimal practitioner support (BPT-S), or a waitlist control group (WL). The study showed that BPT implemented by briefly trained social service employees (BPT-P) resulted in at least as large effects as previous efficacy studies. PMT-S also showed significant effects compared to the WL, but was less effective than PMT-P. Improvements in child behaviors were mediated by improved parenting behaviors. Study II investigated the effects of an enhanced version of the BPT-program from study I. The program targeted families with risk factors for non-response that were referred to service within the social services. The results showed strong intervention effects on child EBP and parent anxiety/depression for enhanced BPT compared to regular BPT. Study III used a randomized design to evaluate the effects of a standardized and feasible BTT program. At both posttest and follow-up, significant effects favoring the BTT-group over the active control group were found on student EBP, teacher behavior management, and peer problems. The study also showed that the effect on student EBP was mediated by change in teacher behavior management.
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| 8. |
- Karlberg, Martin, 1969-
(författare)
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Skol-Komet : Tre utvärderingar av ett program för beteendeorienterat ledarskap i klassrummet
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Children who express externalizing behaviors in school are at greater risk of school failure and peer rejection. They are also at greater risk of developing antisocial behaviors, addiction to drugs, mental health problems and delinquency. Many teachers experience difficulties in working with pupils expressing externalizing behaviors. The aim of this thesis is to evaluate a classroom behavior management program called Comet. The main principle of Comet is to get the teacher to use effective strategies when the pupil who is targeted for intervention, and the rest of class, are behaving appropriately and inappropriately. Two versions of the program are evaluated in the thesis: Comet for teachers (Comet-T) and Comet for parents (Comet-P). Three studies are committed to evaluate Comet-T. In the first study Comet-T was compared to an active control group. 100 children (aged 8) were randomized into Comet-T or the control group. At post test and follow-up Comet-T received a better results in reducing externalizing problems, peer problems and teacher behavior management. An analysis of mediators showed that changes in teacher behaviors mediated externalizing behavior. In the second study, children (aged 6 -13) were randomized into two groups. 44 pupils received Comet-T and 42 pupils received a combined intervention consisting of Comet-T at school and Comet-P at home. At post test and follow-up the results show that the combination of Comet-T and Comet-P reduced the externalizing behaviors at home more than Comet-T (only). However, there were no significant differences between the two conditions regarding decrease in externalizing behaviors at school. In the third study Comet-T was compared to a brief version called Comet-TB. At post test Comet-TB had a greater reduction of externalizing behaviors compared to Comet-T. The studies conclude that teachers can use behavior management techniques to decrease externalizing behaviors in the classroom. Furthermore, teachers cannot rely on parent management programs in order to decrease externalizing problems in school. Instead, behavior problems in school need to be solved within school settings. Finally, even a brief program can be effective in order to decrease externalizing behaviors.
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| 9. |
- Kling, Åsa, et al.
(författare)
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A Randomized Controlled Effectiveness Trial of Parent Management Training With Varying Degrees of Therapist Support
- 2010
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Ingår i: Behavior Therapy. - Elsevier : Elsevier BV. - 0005-7894 .- 1878-1888. ; 41:4, s. 530-542
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the effectiveness of a Swedish parent management training (PMT) intervention for parents of children aged 3 to 10 within the context of regular social service. Self-referred parents of 159 children (aged 3–10) with conduct problems were randomly assigned to either eleven practitioner-assisted group sessions (PMT-P), or a single instructional workshop followed by self-administration of the training material (PMT-S), or a waitlist control group. Intent-to-treat analyses showed that both PMT-P and PMT-S improved parent competence and reduced child conduct problems compared to the waitlist at posttest. Both training conditions showed further significant improvements at the 6-month follow-up. In direct comparison, PMT-P was superior to PMT-S on measures of child conduct problems at both posttest and follow-up. Improvement in child conduct was mediated by improvement in parent competencies and homework fidelity. The findings in this study have implications for large-scale dissemination of parent management training through different means of delivery.
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| 10. |
- Modin, Bitte, et al.
(författare)
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Psychosocial working conditions, school sense of coherence and subjective health complaints : A multilevel analysis of ninth grade pupils in the Stockholm area
- 2011
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Ingår i: Journal of Adolescence. - : Wiley. - 0140-1971 .- 1095-9254. ; 34:1, s. 129-139
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Tidskriftsartikel (refereegranskat)abstract
- This study explores the psychosocial working conditions of 7930 Swedish 9th grade students, distributed over 475 classes and 130 schools, in relation to their subjective health using multilevel modeling. At the individual level, students with “strained” working conditions in school (i.e. those experiencing a high level of demands in combination with a low level of control) demonstrated significantly worse health compared to students in “low-strain” situations. “Strained” conditions in combination with a weak school-related sense of coherence were especially unfavourable for health. These findings remained significant when support from teachers, school marks, norm-breaking behaviours, family-relations and certain class- and school-contextual conditions were adjusted for. Thus, while demands are an essential part of school work, this study suggests that high levels of control and a strong school-related sense of coherence can protect against the more detrimental effects on health that high demands at school may cause.
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