JSSM  Vol.7 No.3 , June 2014
Predictors of Effectiveness in a Multifamily Therapy Program for Adolescents with Externalizing Behaviors
Abstract: Severe externalizing behavior among adolescents is a significant societal problem, in terms of both emotional and financial costs. Much research has focused on factors that increase or decrease the risk of adolescents developing such behavior. In addition, various treatment methods have been developed to address this problem, with promising results under some circumstances. The present study examined archival data from one multifamily therapy program to examine potential predictors of the effectiveness of treatment. These predictors were communication style and relationship quality between parents and adolescents, as well as parents’ readiness for change. Parent-adolescent relationship quality and communication style were both found to significantly predict treatment outcomes in some, but not all, problem areas examined. Parent readiness did not predict treatment outcomes. Results have implications for improving the clinical outcomes of family treatment programs.
Cite this paper: Feldblyum, J. , Williams, D. , Walker, J. and Jackson-Walker, S. (2014) Predictors of Effectiveness in a Multifamily Therapy Program for Adolescents with Externalizing Behaviors. Journal of Service Science and Management, 7, 245-259. doi: 10.4236/jssm.2014.73022.

[1]   Barkley, R.A., Geuvremont, D.G., Anastopoulos, A. D., DuPaul, G.J. and Shelton, T.L. (1993) Driving-Related Risks and Outcomes of Attention Deficit Hyperactivity Disorder in Adolescents and Young Adults: A 3-5 Year Follow-Up Survey. Pediatrics, 92, 212-218.

[2]   Hartsough, C.S. and Lambert, N.M. (1985) Medical Factors in Hyperactive and Normal Children: Prenatal, Developmental, and Health History Findings. American Journal of Orthopsychiatry, 55, 190-210.

[3]   Liu, J. (2004) Childhood Externalizing Behavior: Theory and Implications. Journal of Child and Adolescent Psychiatric Nursing, 17, 93-103.

[4]   Moilanen, K., Shaw, D.S. and Maxwell, K.L. (2010) Developmental Cascades: Externalizing, Internalizing and Academic Competence from Middle Childhood to Early Adolescence. Development and Psychopathology, 22, 637-655.

[5]   Amerikaner, M., Monks, G., Wolfe, P. and Thomas, S. (1994) Family Interaction and Individual Psychological Health. Journal of Counseling and Development, 72, 614-620.

[6]   Aspy, C., Oman, R., Vesely, S., McLeroy, K., Rodine, S. and Marshall, L. (2004) Adolescent Violence: The Protective Effects of Youth Assets. Journal of Counseling and Development, 82, 268-276.

[7]   Clark, R.D. and Shields, G. (1997) Family Communication and Delinquency. Adolescence, 32, 81-92.

[8]   Caprara, G., Regalia, C. and Bandura, A. (2002) Longitudinal Impact of Perceived Self-Regulatory Efficacy on Violent Conduct. European Psychologist, 7, 63-69.

[9]   Madden-Derdich, D.A., Leonard, S.A. and Gunnell, G.A. (2002) Parents’ and Children’s Perceptions of Family Processes in Inner-City Families with Delinquent Youths: A Qualitative Investigation. Journal of Marital and Family Therapy, 28, 355-369.

[10]   Friedman, A.S., Tomko, L.A. and Utada, A. (1991) Client and Family Characteristics that Predict Better Family Therapy Outcome for Adolescent Drug Abusers. Family Dynamics of Addiction Quarterly, 1, 77-93.

[11]   Kaminski, J., Valle, L., Filene, J.H. and Boyle, C.L. (2008) A Meta-Analytic Review of Components Associated with Parent Training Program Effectiveness. Journal of Abnormal Child Psychology, 36, 567-589.

[12]   Miner, J.L. and Clarke-Stewart, K. (2008) Trajectories of Externalizing Behavior from Age 2 to Age 9: Relations with Gender, Temperament, Ethnicity, Parenting, and Rater. Developmental Psychology, 44, 771-786.

[13]   Shechtman, Z. and Gilat, I. (2005) The Effectiveness of Counseling Groups in Reducing Stress of Parents of Children with Learning Disabilities. Group Dynamics: Theory, Research, and Practice, 9, 275-286.

[14]   Perkins-Dock, R.E. (2001) Family Interventions with Incarcerated Youth: A Review of the Literature. International Journal of Offender Therapy and Comparative Criminology, 45, 606-625.

[15]   Kazdin, A.E. (2010) Problem-Solving Skills Training and Parent Management Training for Oppositional Defiant Disorder and Conduct Disorder. In: Weisz, J.R. and Kazdin, A.E., Eds., Evidence-Based Psychotherapies for Children and Adolescents, 2nd Edition, Guilford Press, New York, 159-178.

[16]   Fossum, S., Mørch, W., Handegard, B., Drugli, M. and Larsson, B. (2009) Parent Training for Young Norwegian Children with ODD and CD Problems: Predictors and Mediators of Treatment Outcome. Scandinavian Journal of Psychology, 50, 173-181.

[17]   Kazdin, A. and Wassell, G. (2000) Therapeutic Changes in Children, Parents and Families Resulting from Treatment of Children with Conduct Problems. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 414-420.

[18]   McAuley, R. (1982) Training Parents to Modify Conduct Problems in Their Children. Journal of Child Psychology and Psychiatry, 23, 335-342.

[19]   Forgatch, M.S. and Patterson, G.R. (2010) Parent Management Training-Oregon Model: An Intervention for Antisocial Behavior in Children and Adolescents. In: Weisz, J.R. and Kazdin, A.E., Eds., Evidence-Based Psychotherapies for Children and Adolescents, 2nd Edition, Guilford Press, New York, 159-178.

[20]   Quinn, W.H. (2004) Family Solutions for Youth at Risk: Applications to Juvenile Delinquency, Truancy and Behavior Problems. Brunner-Routledge, New York.

[21]   Meezan, W. and O’Keefe, M. (1998) Multifamily Group Therapy: Impact on Family Functioning and Child Behavior. Families in Society, 79, 32-44.

[22]   Prochaska, J.O. and DiClemente, C.C. (1983) Stages and Processes of Self-Change of Smoking: Toward an Integrative Model of Change. Journal of Consulting and Clinical Psychology, 51, 390-395.

[23]   Norcross, J.C., Krebs, P.M. and Prochaska, J.O. (2011) Stages of Change. Journal of Clinical Psychology, 67, 143-154.

[24]   Sefton-Silver, S. (1997) Stages of Change within Families Presenting a Child for Weight Management Services: Implications for Compliance and Outcome. Dissertation Abstracts International, Section B: Sciences and Engineering, 57, 6593.

[25]   Sells, S.P. (1998) Treating the Tough Adolescent: A Family-Based, Step-by-Step Guide. Guilford Press, New York.

[26]   Sells, S.P. (2001) Parenting Your Out-of-Control Teenager: 7 Steps to Reestablish Authority & Reclaim Love. St. Martin’s Press, New York.

[27]   Substance Abuse and Mental Health Services Administration (2008) Intervention Summary: Parenting with Love and Limits.

[28]   Sells, S.P., Early, K.W. and Smith, T.E. (2011) Reducing Adolescent Oppositional and Conduct Disorders: An Experimental Design Using the Parenting with Love and Limits Model. Professional Issues in Criminal Justice, 6, 9-30.

[29]   Bishaw, A. and Semega, J. (2008) Income, Earnings and Poverty Data from the 2007 American Community Survey (Research Report No. ACS-09).

[30]   United States Census Bureau (n.d.) American FactFinder [Internet-Based Data Query].

[31]   Hudson, W.W., Wung, B. and Borges, M. (1980) Parent-Child Relationship Disorders: The Parent’s Point of View. Journal of Social Service Research, 3, 283-294.

[32]   Barnes, H.L. and Olson, D.H. (1985) Parent-Adolescent Communication and the Circumplex Model. Child Development, 56, 438-447.

[33]   DiClemente, C.C. and Hughes, S.O. (1990) Stages of Change Profiles in Outpatient Alcoholism Treatment. Journal of Substance Abuse, 2, 217-235.

[34]   DiClemente, C.C., Schlundt, D. and Gemmell, L. (2004) Readiness and Stages of Change in Addiction Treatment. The American Journal on Addictions, 13, 103-119.

[35]   Achenbach, T.M. (1991) Manual for Child Behavior Checklist/ 4-18 and 1991 Profile. University of Vermont, Department of Psychiatry, Burlington.

[36]   Consortium for Longitudinal Studies of Child Abuse and Neglect (n.d.) Child Behavior Checklist/4-18.

[37]   Cohen, J. (1988) Statistical Power Analysis for the Behavioral Sciences. 2nd Edition, Erlbaum, Hillside.

[38]   Phares, V., Fields, S., Kamboukos, D. and Lopez, E. (2005) Still Looking for Poppa. American Psychologist, 60, 735-736.

[39]   Dishion, T.J. and Andrews, D.W. (1995) Preventing Escalation in Problem Behaviors with High-Risk Young Adolescents: Immediate and 1-Year Outcomes. Journal of Consulting and Clinical Psychology, 63, 538-548.

[40]   Walker, J.P. and Feldblyum, J. (2010) Family Connections: Quick Facts for 2010. Unpublished Data.

[41]   Sheidow, A.J. and Woodford, M.S. (2003) Multisystemic Therapy: An Empirically Supported, Home-Based Family Therapy Approach. The Family Journal, 11, 257-263.