Kristine Amlund Hagen

Treatment Outcomes and Mediators of Parent Management Training: A One-Year Follow-Up of Children with Conduct Problems

This effectiveness study presents the results of a 1-year follow-up of a randomized controlled trial of Parent Management Training. Families of 112 Norwegian girls and boys with clinic-level conduct problems participated, and 75 (67%) families were retained at follow-up. Children ranged in age from 4 to 12 at intake (M = 8.44). Families randomized to the control group received an active treatment alternative as would be normally offered by participating agencies. Multi-informant, multisetting outcome measures were collected and results from both intention-to-treat and treatment-on-the-treated analyses are presented. In two separate indirect effects models, assignment to Parent Management Training—the Oregon model predicted greater effective discipline and family cohesion at postassessment, which in turn predicted improvements in several child domains at follow-up.

Implementing and Evaluating Evidence-Based Treatments of Conduct Problems in Children and Youth in Norway

This article sums up 8 years of experience with evidence-based programs in the treatment of conduct problems in children and youth. A conceptual model describing the implementation components relevant to the Norwegian project is presented and discussed. Next, we describe a case study of the implementation strategy accompanied by outcomes from the clinical trials of Multisystemic Therapy (MST) and Parent Management Training—the Oregon model (PMTO). The national implementation strategy for evidence-based treatment programs is a combination of a ‘‘top-down’’ and ‘‘bottom-up’’ approach to implementation based on collaborative efforts of a national center for dissemination, implementation, and research and the public child and adolescent service system operating in the municipalities. The strategy further includes recruitment of candidates for training through the various service systems and the establishment of permanent networks for collaboration, supervision, and support.

Sustainability of the effectiveness of a programme of multisystemic treatment (MST) across participant groups in the second year of operation

In order to examine the sustainability of programme effectiveness, we investigated whether the effects of multisystemic treatment (MST) on a second group of adolescents would match those reported in an earlier randomised controlled trial (RCT). Pre‐ and post‐treatment assessments were analysed in a participant group of 105; 55 youths were referred to MST in the programmes second year of operation (MST2), and 50 youths were included in the RCT the first year in which 30 were randomly assigned to MST (MST1) and 20 to regular services (RS).At two project sites, MST clinical outcomes in the second year of programme operation matched and, for key indices of anti‐social behaviour, surpassed those achieved during the first year. In addition the MST treatment delivered in the second year was more effective than regular child welfare services in preventing out of home placement and reducing internalising and externalising behaviour. Together, these results demonstrated sustained effectiveness of the programme as well as indication of programme maturation effects. No group differences were registered for social competence. MST youths treated in the second year were significantly younger than those referred to treatment in the first year (MST1) but age had no moderating effect on the outcomes.

Building strength through enhancing social competence in immigrant students in primary school. A pilot study

In the present pilot study we examined how a school‐wide intervention model, ‘Positive behavior, interactions and learning environment in school’ (Norwegian acronym: PALS) contributed to risk reduction in immigrant students through the promotion of social competence. The aims of the PALS project were to promote social competence through positive behavior support and to prevent and reduce problem behavior in students. Teachers and students in selected grade levels at four elementary schools and four comparison schools participated in a quasi‐experimental evaluation spanning over 20 months. The present study was conducted with a subset of the students, namely the 6.7% (n = 49) immigrant students who had Norwegian as their second language. Consistent with the social learning theory underlying the PALS model, teacher reports indicated that immigrant students in the intervention group were significantly more socially competent than were their counterparts in the comparison group at post‐test when school differences at pre‐assessment were accounted for. A significant decrease in internalizing problem behavior was registered in teacher ratings along with a marginally significant positive trend in teacher‐rated academic progress. No intervention effect was registered in teacher‐rated externalizing problem behavior or in student ratings of social competence. In order to measure potential generalizing effects of school‐wide intervention programs, we discuss the need for larger samples and longer follow‐up periods.

What works for whom? Gender differences in intake characteristics and treatment outcomes following Multisystemic Therapy

AIMS OF THE STUDY We investigated whether girls and boys had similar referral symptoms and background characteristics at intake to Multisystemic Therapy (MST) and whether adolescent girls with serious behavior problems benefited as much from MST treatment as did boys. We also examined gender differences in rate of co-morbidity at intake and whether the families of boys and girls referred to MST differed in their evaluation of the treatment received. METHOD Participants were 117 Norwegian adolescent girls (35%) and boys (65%), ranging in age from 12 to 17 (M=14.58), referred to MST treatment in the first and second year of the program operation. RESULTS Gender differences appeared for some referral reasons, intake characteristics and treatment changes, but the similarities between girls and boys far outnumbered their differences. CONCLUSIONS Although girls may present a somewhat different problem profile than do boys and their risk factors for developing conduct problems may be somewhat different, MST seemed flexible and robust enough to be effective for most adolescents in the present sample, regardless of gender.