Maaskant Anne M, van Rooij Floor B, Overbeek Geertjan J, Oort Frans J, Arntz Maureen, Hermanns Jo M A
Research Institute Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands.
H&S Consult, Woerden, The Netherlands.
J Child Fam Stud. 2017;26(2):523-539. doi: 10.1007/s10826-016-0579-2. Epub 2016 Oct 12.
The present randomized controlled trial examined the effectiveness of Parent Management Training Oregon for foster parents with foster children (aged 4-12) with severe externalizing behavior problems in long-term foster care arrangements. Foster children's behavior problems are challenging for foster parents and increase the risk of placement breakdown. There is little evidence for the effectiveness of established interventions to improve child and parent functioning in foster families. The goal of Parent Management Training Oregon, a relatively long and intensive (6-9 months, with weekly sessions) parent management training, is to reduce children's problem behavior through improvement of parenting practices. We specifically investigated whether Parent Management Training Oregon is effective to reduce foster parenting stress. A significant effect of Parent Management Training Oregon, compared to Care as Usual was expected on reduced parenting stress improved parenting practices, and on reduced child behavior problems. Multi-informant (foster mothers, foster fathers, and teachers) data were used from 86 foster families (46 Parent Management Training Oregon, 40 Care as Usual) using a pre-posttest design. Multilevel analyses based on the intention to treat principle (retention rate 73 %) showed that Parent Management Training Oregon, compared to Care as Usual, reduced general levels of parenting stress as well as child related stress and parent-related stress (small to medium effect sizes). The clinical significance of this effect was, however, limited. Compared to a decrease in the Care as Usual group, Parent Management Training Oregon helped foster mothers to maintain parental warmth (small effect size). There were no other effects of Parent Management Training Oregon on self-reported parenting behaviors. Child behavior problems were reduced in both conditions, indicating no additive effects of Parent Management Training Oregon to Care as Usual on child functioning. The potential implication of reduced foster parenting stress for placement stability is discussed.
本随机对照试验考察了俄勒冈家长管理培训对长期寄养安排中照顾有严重外化行为问题（4至12岁）寄养儿童的养父母的效果。寄养儿童的行为问题对养父母来说具有挑战性，并增加了安置失败的风险。对于改善寄养家庭中儿童和家长功能的既定干预措施的有效性，几乎没有证据支持。俄勒冈家长管理培训是一种相对较长且密集（6至9个月，每周上课）的家长管理培训，其目标是通过改善养育方式来减少儿童的问题行为。我们专门调查了俄勒冈家长管理培训在减轻寄养家长压力方面是否有效。与常规照护相比，预计俄勒冈家长管理培训在减轻养育压力、改善养育方式以及减少儿童行为问题方面会有显著效果。采用前后测设计，从86个寄养家庭（46个接受俄勒冈家长管理培训，40个接受常规照护）收集了多渠道（寄养母亲、寄养父亲和教师）数据。基于意向性分析原则（保留率73%）的多水平分析表明，与常规照护相比，俄勒冈家长管理培训降低了总体养育压力水平以及与孩子相关的压力和与家长相关的压力（效应量为小到中等）。然而，这一效果的临床意义有限。与常规照护组的下降情况相比，俄勒冈家长管理培训帮助寄养母亲保持了父母的温情（效应量小）。俄勒冈家长管理培训在自我报告的养育行为方面没有其他效果。两种情况下儿童行为问题都有所减少，这表明俄勒冈家长管理培训与常规照护相比，在儿童功能方面没有附加效果。文中讨论了减轻寄养家长压力对安置稳定性的潜在影响。
