To test a school-based therapy intervention, McArdle
et al. (2002) asked teachers to identify high-risk students in a high
unemployment area of North Tyneside, England. The risk factors included
scholastic under-performance, family problems, poor nourishment and
care, impaired peer relationships, and behavioral/emotional difficulties.
Groups of eight students were then randomly allocated to 12-week programs
consisting of either a group therapy condition or a curriculum studies
condition. The group therapy condition combined creative-expressive
and psychodrama approaches whereby students first built up mutual trust
and then acted out and explored troubling situations that they had encountered.
The curriculum studies condition combined individual tutoring and group
teaching. Assessment instruments included the YSR and the Multidimensional
Self-Concept Scale (MSCS) completed by the participating students; the
CBCL completed by their parents; and the TRF completed by their teachers
prior to the interventions, immediately following the interventions,
and again a year later. A strong feature of the outcome assessment was
that the 1-year follow-up TRFs were completed by different teachers
than those who completed the earlier TRFs, because all students had
changed teachers and most had changed schools. The teachers who completed
the follow-up TRFs were blind as to intervention status. For the 105
students who completed the study, the MSCS and the Internalizing, Externalizing,
and Total Problems scores of the YSR and TRF showed significant declines
from pre- to post-intervention to follow-up assessments for both the
group therapy and curriculum studies conditions. In addition, the TRF
Internalizing, Externalizing, and Total Problems scores showed significant
interactions between the three assessment points and the two intervention
conditions. These interactions revealed that improvements were significantly
greater for the group therapy condition than for the curriculum studies
condition. Although self-ratings and teacher ratings both indicated
improvements, the TRF scores indicated more improvement in the group
therapy than in the curriculum studies condition. McArdle et al. also
compared TRF scores before vs. after a 1-term waiting-list control period
prior to the beginning of the interventions. No significant changes
occurred in TRF Internalizing, Externalizing, or Total Problems scores
during the waiting-list period, indicating that neither the passage
of time nor repeated ratings by teachers accounted for the improvements
found in the post-intervention comparisons. Furthermore, only students
receiving group therapy showed significantly greater improvements from
pre- to post-intervention than during the waiting period. The authors
concluded that "education and health professionals and managers
should consider including group-work-based early interventions in the
development of new child health services or in the overall management
of behavioral and emotional problems in school" (p. 711).
Reference:
McArdle, P., Mosely, D., Quibell, T., Johnson, R., Allen, A., Hammal,
D., & leCouteur, A. (2002) School-based indicated prevention: a
randomised trial of group therapy. Journal of Child Psychology and
Psychiatry, 43, 705-712.