A Comprehensive Review of Prevention Groups for Children and Adolescents.

Primary prevention has increasingly become a focus of the child and adolescent research literature over the past 25 years. Groups are a natural milieu within which to work with children and adolescents. The current research reviews the literature on child and adolescent prevention-oriented group interventions for the decade 1990-2000 to follow up the work of previous reviews in this area, identify current trends, and suggest future directions for the literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevention groups: The shape of things to come.

This introductory article by the editors summarizes the intent, content, and procedures of the special issue and makes a supportive case for the future of effective prevention groups that draws from the pioneer research contained within it. Researchers are summoned to prioritize prevention groups as an important and viable focal area, journals are encouraged to welcome research of this topic (without altering acceptance criteria), concurrence about definitions of key processes and concepts (i.e., how to define prevention groups) is urged, and others are encouraged to draw lessons from the research of the authors contained in the special issue. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized clinical trial of a computer based preventive intervention: Replication and extension of ePREP.

This randomized clinical trial replicated the efficacy of the ePREP preventive intervention for mental health and relationship relevant outcomes in a sample of 77 college students. It extended previous research by demonstrating efficacy at a 10-month follow up. Participants in the ePREP condition experienced improved mental health and relationship relevant outcomes relative to those who received a placebo intervention. The impact of the ePREP intervention on these outcomes was durable to relationship dissolution with and without repartnering. The flexibility of this intervention empowers it to overcome key obstacles in the dissemination of relationship education. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: A randomized efficacy trial.

In this depression prevention trial, 341 high-risk adolescents (mean age = 15.6 years, SD = 1.2) with elevated depressive symptoms were randomized to a brief group cognitive-behavioral (CB) intervention, group supportive-expressive intervention, bibliotherapy, or assessment-only control condition. CB participants showed significantly greater reductions in depressive symptoms than did supportive-expressive, bibliotherapy, and assessment-only participants at posttest, though only the difference compared with assessment controls was significant at 6-month follow-up. CB participants showed significantly greater improvements in social adjustment and reductions in substance use at posttest and 6-month follow-up than did participants in all 3 other conditions. Supportive-expressive and bibliotherapy participants showed greater reductions in depressive symptoms than did assessment-only controls at certain follow-up assessments but produced no effects for social adjustment and substance use. CB, supportive-expressive, and bibliotherapy participants showed a significantly lower risk for major depression onset over the 6-month follow-up than did assessment-only controls. The evidence that this brief CB intervention reduced risk for future depression onset and outperformed alternative interventions for certain ecologically important outcomes suggests that this intervention may have clinical utility. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy trial of a brief cognitive–behavioral depression prevention program for high-risk adolescents: Effects at 1- and 2-year follow-up.

Objective: To evaluate the effects of a brief group cognitive–behavioral (CB) depression prevention program for high-risk adolescents with elevated depressive symptoms at 1- and 2-year follow-up. Method: In this indicated prevention trial, 341 at-risk youths were randomized to a group CB intervention, group supportive expressive intervention, CB bibliotherapy, or educational brochure control condition. Results: Significantly greater reductions in depressive symptoms were shown by group CB participants relative to brochure control participants by 1-year follow-up and bibliotherapy participants by 1- and 2-year follow-up but not relative to supportive expressive participants. Supportive expressive participants showed greater symptom reduction than CB bibliotherapy participants did at 2-year follow-up. Risk for onset of major or minor depression over the 2-year follow-up was significantly lower for group CB participants (14%; odds ratio = 2.2) and CB bibliotherapy participants (3%; odds ratio = 8.1) than for brochure controls (23%). Conclusions: Results indicate that this group CB intervention reduces initial symptoms and risk for future depressive episodes, although both supportive expressive therapy and CB bibliotherapy also produce intervention effects that persist long term. Indeed, CB bibliotherapy emerged as the least expensive method of reducing risk for future episodes of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Promoting healthy beginnings: A randomized controlled trial of a preventive intervention to preserve marital quality during the transition to parenthood.

Couples expecting their first child were randomly assigned to intervention (n = 28) and comparison groups (n = 38) to assess the efficacy of a couples intervention and examine marital satisfaction trajectories across the transition to parenthood. The primarily European American sample (M age = 30 years) completed assessments of marital satisfaction at 5 points from the final trimester of pregnancy to 66 months postpartum. Growth curve analyses indicated a normative linear decline in marital satisfaction. Intervention participants experienced significantly less decline than comparison participants, providing support for the efficacy of the intervention. Comparable childless couples (n = 13) did not show a decline in marital satisfaction. The results suggest that early family transitions that strain couple relationships provide critical opportunities for preventive interventions to strengthen marriage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of web-based personalized normative feedback: A two-year randomized controlled trial.

Objective: Web-based brief alcohol interventions have the potential to reach a large number of individuals at low cost; however, few controlled evaluations have been conducted to date. The present study was designed to evaluate the efficacy of gender-specific versus gender-nonspecific personalized normative feedback (PNF) with single versus biannual administration in a 2-year randomized controlled trial targeting a large sample of heavy-drinking college students. Method: Participants included 818 freshmen (57.6% women; 42% non-Caucasian) who reported 1 or more heavy-drinking episodes in the previous month at baseline. Participants were randomly assigned in a 2 (gender-specific vs. gender-nonspecific PNF) × 2 (single vs. biannual administration of PNF) + 1 (attention control) design. Assessments occurred every 6 months for a 2-year period. Results: Results from hierarchical generalized linear models provided modest effects on weekly drinking and alcohol-related problems but not on heavy episodic drinking. Relative to control, gender-specific biannual PNF was associated with reductions over time in weekly drinking (d = ?0.16, 95% CI [?0.02, ?0.31]), and this effect was partially mediated by changes in perceived norms. For women, but not men, gender-specific biannual PNF was associated with reductions over time in alcohol-related problems relative to control (d = ?0.29, 95% CI [?0.15, ?0.58]). Few other effects were evident. Conclusions: The present research provides modest support for the use of biannually administered web-based gender-specific PNF as an alternative to more costly indicated prevention strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using the internet to assist smoking prevention and cessation in schools: A randomized, controlled trial.

Objective: To evaluate the impact of a classroom-based, Web-assisted tobacco intervention addressing smoking prevention and cessation with adolescents. Design: A two-group randomized control trial with 1,402 male and female students in grades 9 through 11 from 14 secondary schools in Toronto, Canada. Participants were randomly assigned to a tailored Web-assisted tobacco intervention or an interactive control condition task conducted during a single classroom session with e-mail follow-up. The cornerstone of the intervention was a five-stage interactive Web site called the Smoking Zine (http://www.smokingzine.org) integrated into a program that included a paper-based journal, a small group form of motivational interviewing, and tailored e-mails. Main Outcome Measure: Resistance to smoking, behavioral intentions to smoke, and cigarette use were assessed at baseline, postintervention, and three- and six-month follow-up. Multilevel logistic growth modeling was used to assess the effect of the intervention on change over time. Results: The integrated Smoking Zine program helped smokers significantly reduce the likelihood of having high intentions to smoke and increased their likelihood of high resistance to continued cigarette use at 6 months. The intervention also significantly reduced the likelihood of heavy cigarette use adoption by nonsmokers during the study period. Conclusion: The Smoking Zine intervention provided cessation motivation for smokers most resistant to quitting at baseline and prevented nonsmoking adolescents from becoming heavy smokers at 6 months. By providing an accessible and attractive method of engaging young people in smoking prevention and cessation, this interactive and integrated program provides a novel vehicle for school- and population-level health promotion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of coping-oriented couples therapy on depression: A randomized clinical trial.

The aim of this study was to evaluate the effectiveness of treating depression with coping-oriented couples therapy (COCT) as compared with cognitive-behavioral therapy (CBT; A. T. Beck, C. Ward, & M. Mendelson, 1961) and interpersonal psychotherapy (IPT; M. M. Weissman, J. C. Markowitz, & G. L. Klerman, 2000). Sixty couples, including 1 clinically depressed partner, completed pre- and posttest questionnaires as well as follow-up assessments at 6-month intervals over the subsequent 1.5 years. Effects of the 3 treatments on depressive symptomatology assessed by the Beck Depression Inventory (A. T. Beck, A. J. Rush, B. L. Shaw, & G. Emery, 1979) and Hamilton Rating Scale for Depression (M. Hamilton, 1960); recovery rates; and relapse rates were examined. Additionally, changes in relationship quality were evaluated. Results suggest that the COCT is as effective in improving depressive symptomatology as are the well-established, evidenced-based CBT and IPT approaches. The COCT did not demonstrate a significantly better outcome with regard to self-reported relationship satisfaction or dyadic coping; however, it did produce significant improvements in partners' expressed emotion, changes that were not seen in other treatment conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of response to treatment in a randomized clinical trial of marital therapy.

This study investigated demographic, intrapersonal, and interpersonal predictors of treatment response in a randomized clinical trial of 134 distressed married couples, which examined traditional (N. S. Jacobson & G. Margolin, 1979) and integrative (N. S. Jacobson & A. Christensen, 1996) behavioral couple therapy. Results based on hierarchical linear modeling revealed that interpersonal variables were the strongest predictors, but their effects were largely limited to predicting initial marital dissatisfaction; greater individual mental health was also associated with less distress initially. Couples who were married longer demonstrated stronger treatment gains, and exploratory analyses suggested that sexually dissatisfied couples showed slower initial, but overall more consistent, gains in the integrative versus the traditional approach. Findings are considered in light of the previous literature on predicting response to marital therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff.

Gatekeeper-training programs, designed to increase identification and referral of suicidal individuals, are widespread but largely untested. A group-based randomized trial with 32 schools examined impact of Question, Persuade, Refer (QPR) training on a stratified random sample of 249 staff with 1-year average follow-up. To test QPR impact, the authors introduced and contrasted 2 models of gatekeeper-training effects in a population: gatekeeper surveillance and gatekeeper communication. Intent-to-treat analyses showed that training increased self-reported knowledge (effect size [ES] = 0.41), appraisals of efficacy (ES = 1.22), and service access (ES = 1.07). Training effects varied dramatically. Appraisals increased most for staff with lowest baseline appraisals, and suicide identification behaviors increased most for staff already communicating with students about suicide and distress. Consistent with the communication model, increased knowledge and appraisals were not sufficient to increase suicide identification behaviors. Also consistent with the communication model were results from 2,059 8th and 10th graders surveyed showing that fewer students with prior suicide attempts endorsed talking to adults about distress. Skill training for staff serving as "natural gatekeepers" plus interventions that modify students' help-seeking behaviors are recommended to supplement universal gatekeeper training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of family foundations on parents and children: 3.5 years after baseline.

This study investigated the ability of a psychosocial prevention program implemented through childbirth education programs to enhance the coparental and couple relationship, parental mental health, the parent-child relationship, and child outcomes. A sample of 169 heterosexual, adult couples expecting their first child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of eight classes delivered before and after birth, which was designed as a universal prevention program (i.e., applicable to all couples, not just those at high risk). Intent-to-treat analyses utilizing data collected from child age 6 months through 3 years indicated significant program effects on parental stress and self-efficacy, coparenting, harsh parenting, and children's emotional adjustment among all families, and maternal depression among cohabiting couples. Among families of boys, program effects were found for child behavior problems and couple relationship quality. These results indicate that a universal prevention approach at the transition to parenthood focused on enhancing family relationships can have a significant and substantial positive impact on parent and child well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bully Busters abbreviated: Evaluation of a group-based bully intervention and prevention program.

The present study sought to examine the efficacy of an abbreviated version of the Bully Busters program, a psychoeducationally based group intervention and prevention program designed to increase teacher's knowledge and use of bullying intervention skills, as well as teacher self-efficacy in intervening with bullying so as to subsequently effect change in the school climate. Teacher-participants attended seven group sessions designed to provide them with exposure to the didactics of the model, as well as to engage them in active learning, role-playing, and cognitive and emotional processing of their experiences of the impact of bullying behaviors on their teaching efficacy as well as the school climate. Materials and experiences from these groups were then taken to the classroom and implemented with the student-participants vis-à-vis classroom exercises. The findings suggest that an abbreviated group-based version of the Bully Busters program can have positive effect on teacher reports of efficacy in intervening with bullying behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized trial of treatment for children with sexual behavior problems: Ten-year follow-up.

This study prospectively follows 135 children 5-12 years of age with sexual behavior problems from a randomized trial comparing a 12-session group cognitive-behavioral therapy (CBT) with group play therapy and follows 156 general clinic children with nonsexual behavior problems. Ten-year follow-up data on future juvenile and adult arrests and child welfare perpetration reports were collected. The CBT group had significantly fewer future sex offenses than the play therapy group (2% vs. 10%) and did not differ from the general clinic comparison (3%), supporting the use of short-term CBT. There were no group differences in nonsexual offenses (21%). The findings do not support assumptions about persistent or difficult to modify risk and raise questions about policies and practices founded on this assumption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

This study examines 1-year depressive symptom and functional outcomes of 267 predominantly lowincome, young minority women randomly assigned to antidepressant medication, group or individual cognitive- behavioral therapy (CBT), or community referral. Seventy-six percent assigned to medications received 9 or more weeks of guideline-concordant doses of medications; 36% assigned to psychotherapy received 6 or more CBT sessions. Intent-to-treat, repeated measures analyses revealed that medication (p = .001) and CBT (p = .02) were superior to community referral in lowering depressive symptoms across 1-year follow-up. At Month 12, 50.9% assigned to antidepressants, 56.9% assigned to CBT, and 37.1% assigned to community referral were no longer clinically depressed. These findings suggest that both antidepressant medications and CBT result in clinically significant decreases in depression for low-income minority women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

History of prevention and prevention groups: Legacy for the 21st century.

This article provides a context for this special journal issue devoted to the topic of evidence-based prevention groups. To begin, a history of the field of prevention is presented. Second, the authors highlight how prevention groups have evolved as part of the broader history of prevention. Finally, the authors discuss the implications of the history of prevention and prevention groups for future research and practice in the field of group work. The overall goal of this article is to provide a base of knowledge that practitioners and researchers may utilize to expand and advance the field of prevention group practice and research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized Study of Combined Universal Family and School Preventive Interventions: Patterns of Long-Term Effects on Initiation, Regular Use, and Weekly Drunkenness.

This study reports findings on a combined family and school-based competency-training intervention from an in-school assessment 2.5 years past baseline, as a follow-up to an earlier study of substance initiation. Increased rates of observed alcohol use and an additional wave of data allowed evaluation of regular alcohol use and weekly drunkenness, with both point-in-time and growth curve analyses. Thirty-six rural schools were randomly assigned to (a) a combined family and school intervention condition, (b) a school-only condition, or (c) a control condition. The earlier significant outcome on a substance initiation index was replicated, and positive point-in-time results for weekly drunkenness were observed, but there were no statistically significant outcomes for regular alcohol use. Discussion focuses on factors relevant to the mix of significant longitudinal results within a consistent general pattern of positive intervention-control differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized controlled trial of a family cognitive-behavioral preventive intervention for children of depressed parents.

A family cognitive-behavioral preventive intervention for parents with a history of depression and their 9–15-year-old children was compared with a self-study written information condition in a randomized clinical trial (n = 111 families). Outcomes were assessed at postintervention (2 months), after completion of 4 monthly booster sessions (6 months), and at 12-month follow-up. Children were assessed by child reports on depressive symptoms, internalizing problems, and externalizing problems; by parent reports on internalizing and externalizing problems; and by child and parent reports on a standardized diagnostic interview. Parent depressive symptoms and parent episodes of major depression also were assessed. Evidence emerged for significant differences favoring the family group intervention on both child and parent outcomes; strongest effects for child outcomes were found at the 12-month assessment with medium effect sizes on most measures. Implications for the prevention of adverse outcomes in children of depressed parents are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Performance appraisal for groups: Models and methods for assessing group processes and outcomes for development and evaluation.

This paper guides consulting psychologists in how to help managers and group leaders assess group members' reactions, behaviors, and performance. The results may be used for development in improving group performance and for evaluation in making decisions about group members' pay and assignments. Individual and group-level measures of conditions (pressures and opportunities), input, process, and outcomes are considered. The paper discusses who seeks group assessment, the multiple purposes of assessment, models of group process to guide assessment, what is assessed and when, methods for assessment, and who contributes to the assessment process. Implications for inculcating a culture of assessment and continuous learning within groups and organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Transporting an evidence-based classroom management program for preschoolers with disruptive behavior problems to a school: An analysis of implementation, outcomes, and contextual variables.

The transportability of an evidence-based teacher professional development program, the Incredible Years Classroom Management Program, was evaluated. This study compared the impact of two training methods: self-administered videotape modeling (VM) and self-administered videotape modeling plus consultation (VMC) on teachers' use of classroom management strategies, reductions in disruptive behaviors, acceptability, and contextual barriers of sustaining EBIs in practice settings. Four pairs of teachers (N = 8) were randomly assigned to VM or VMC conditions in a multiple probe design. Students (1-2 per classroom; N = 13) displaying high levels of externalizing problems also participated. Statistically significant between-groups differences in teacher confidence ratings, use of positive instructional practices, and acceptability favored the VMC condition. Positive trends favoring VMC students, including clinically significant increases in social competence, were also found. Although students in both groups exhibited reductions in disruptive behaviors, significant between-groups differences related to disruptive behavior were not observed. Findings related to contextual variables (e.g., time, cost, institutional support, adaptability of the program) have implications for future adoption of this program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)