Clinical Trial of Emotion-Focused Skills Training for Parents

Improving Outcome for Children Through Treatment of Their Parents - Comparing Emotion-Focused Parent Skills Training With Emotion Coaching Parent Program for Children With Externalizing and Internalizing Symptoms: a Randomized Controlled Trial

Children with externalizing and internalizing symptoms has been linked to poor emotional competence, problematic understanding and regulation of emotions. A number of recent studies demonstrates the importance of parents' active involvement in the child's recovery process and support the empirical relationship between parenting style and child symptoms. Emotional awareness and acceptance of painful emotional experience in parents leads to reduction in how these emotions are experienced in response to stressors in children. This makes the parent less vulnerable to rumination or suppression of negative emotional experience related to the child. In addition, it releases parents' emotional capacity to be mentally present and emotionally available for their child. Although neuro-affective principles from research have been incorporated in the therapeutic approaches for adults, there are currently no programs that target these mechanisms in working with children with mental health difficulties. Emotion Focused Skills Training (EFST) is an easily administrated, cost efficient treatment program specifically directed towards the parental role in promoting change in children. In this randomized controlled trial, we will compare experiential process oriented EFST with a psycho-educational version of EFST on parents of children aged 6-13 with externalizing or internalizing symptoms. Parents of 236 children will receive a two days course and 6 hours of individually delivered treatment within a 10 weeks period, either with the experiential version of EFST or the psycho-educational version. Feedback regarding outcome on externalizing and internalizing problems will be obtained from parents and teachers at 5 different periods: baseline, treatment completion and at 3, 6 and 9 months follow-up.

Study Overview

• Status: Completed
• Conditions: F01.318 Child Rearing; F01.470 Emotions; F01.145.179 Child Behavior
• Intervention / Treatment: Behavioral: Emotion-Focused Skills Training for Parents - Experiential; Behavioral: Emotion-Focused Skills Training for Parents - Psychoeducational

• Study Type: Interventional
• Enrollment (Actual): 220
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Norway
  • Bergen, Norway, 5012
    • Institutt for Psykologisk rådgivning

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 years to 13 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Parents of children between 6-13 with either internalizing problems, externalizing problems, or both.
• An overall final assessment of whether it is likely that the parents will be able to fully participate in the study.
• Parents who live with the child at least 50% of the time.
• Parents who agree that they need help and are motivated for the treatment.
• Parents and children who speak Norwegian
• Parents who have the time to participate in the intervention program.
• Parents who are willing to collaborate with the childs school and contact with the school teacher.

Exclusion Criteria:

• Parents: Serious or chronic mental health difficulties such as psychosis, bipolar disorder, organic disorder, ongoing substance abuse, do.
• documented sexual abuse, serious mental health problems, organic disorder and/or disability in the child.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Experiential Condition; This group will receive an experiential version of the program Emotion-Focused Skills Training for Parents, meaning they will engage in tasks that are supposed to activate the parents emotional system, providing them with a deeper sense of understanding towards their child.	Behavioral: Emotion-Focused Skills Training for Parents - Experiential; The intervention consists of a 2-day work shop given in a group format, in addition to 6 hours of parent supervision within 6 weeks after the work shop.; Behavioral: Emotion-Focused Skills Training for Parents - Psychoeducational; The intervention consists of a 2-day work shop given in a group format, in addition to 6 hours of parent supervision within 6 weeks after the work shop.
Active Comparator: Psychoeducational version; This group will receive a non-experiential, psychoeducational version of the program Emotion-Focused Skills Training for Parents, meaning they will not engage in tasks that are meant to activate the parents emotional system.	Behavioral: Emotion-Focused Skills Training for Parents - Experiential; The intervention consists of a 2-day work shop given in a group format, in addition to 6 hours of parent supervision within 6 weeks after the work shop.; Behavioral: Emotion-Focused Skills Training for Parents - Psychoeducational; The intervention consists of a 2-day work shop given in a group format, in addition to 6 hours of parent supervision within 6 weeks after the work shop.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Change in SDQ-P 4-17 - Strengths and Difficulties Questionnaire and impact supplement for the parents of 4-17 year olds All 5 subscales and total score will be used.	Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up
Change in ASEBA Child Behavior Checklist for Ages 6-18 All eight subscales and total scores will be used.	Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up
Change in ASEBA - Child Behavior Checklist - Teacher Report Form All eight subscales and total scores will be used.	Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Outcome Questionnaire 45, Version 2, for the parents	Outcome questionnaire designed to evaluate a psychotherapy client's progress initially and throughout treatment.	Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up
Difficulties in Emotion Regulation Scale		Pre, post, 3 months, 6 months, 9 monthsPre, post (0 months after completed intervention), 3, 6 and 9 months follow up
Forms of Self-Criticising/Attacking & Self-Reassuring Scale All 3 subscales will be used: Inadequate self, Hated self, Reassured self.		Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up

Other Outcome Measures

Outcome Measure	Time Frame
Parents Beliefs About Children's Emotions questionnaire Full scale	Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up
Parents Sense of Competence Scale Full scale	Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up
Coping with Children's Negative Emotion Scale Full scale	Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up
Affect Integration Inventory Full scale: global affect integration	Pre, post (0 months after completed intervention), 3, 6 and 9 months follow up

Collaborators and Investigators

• Sponsor: Institutt for Psykologisk Radgivning
• Collaborators: University of Oslo; University of Bergen; The Research Council of Norway

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2018
• Primary Completion (Actual): July 30, 2020
• Study Completion (Actual): January 30, 2021

Study Registration Dates

• First Submitted: January 14, 2019
• First Submitted That Met QC Criteria: January 15, 2019
• First Posted (Actual): January 16, 2019

Study Record Updates

• Last Update Posted (Actual): August 3, 2022
• Last Update Submitted That Met QC Criteria: August 2, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: Nadia_RCT_2018

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No