Clinical Psychology, School of Psychology, University College Dublin, Dublin 4, Ireland.
Fam Process. 2019 Mar;58(1):232-246. doi: 10.1111/famp.12352. Epub 2018 Mar 9.
The aim of this systematic review and meta-analysis was to examine the effectiveness of Stepping Stones Triple P (SSTP) parent training programs on child behavior problems and parenting outcomes in families of children with developmental disabilities. Sixteen suitable studies including data from over 900 families were identified in a search for English language published and unpublished controlled outcome studies. SSTP has five levels on a graded continuum of increasing intensity targeting families with differing degrees of treatment need from low intensity media-based parenting information campaigns at level 1, through brief interventions at levels 2 and 3, to more intensive parent training and family therapy interventions at levels 4 and 5. Analyses were conducted on the combination of all levels of SSTP and separately for each level. For combined levels, significant overall effect sizes were found for parent-reported child problems (d = 0.46), researcher observed child behavior (d = 0.51), parenting style (d = 0.70), parenting satisfaction/self-efficacy (d = 0.44), parental adjustment (d = 0.27), and coparental relationship (d = 0.26), but not researcher-observed parent behavior. Strong support was found for level 4 SSTP as an effective intervention for improving child and parent outcomes in families of children with disabilities who have clinically significant problems. Less intensive SSTP interventions for cases with circumscribed difficulties yielded fewer significant treatment effects, and there were relatively few studies of such interventions.
本系统评价和荟萃分析的目的是检验阶梯式三重 P(SSTP)家长培训计划在有发育障碍儿童家庭中对儿童行为问题和养育结果的有效性。通过搜索英文发表和未发表的对照结局研究,确定了 16 项合适的研究,其中包括 900 多个家庭的数据。SSTP 有五个等级,从低强度的基于媒体的育儿信息运动(第 1 级)到更集中的家长培训和家庭治疗干预(第 4 级和第 5 级),针对不同治疗需求程度的家庭进行分级。对所有 SSTP 级别进行了组合分析,并对每个级别分别进行了分析。对于综合水平,发现父母报告的儿童问题(d=0.46)、研究人员观察到的儿童行为(d=0.51)、养育风格(d=0.70)、养育满意度/自我效能感(d=0.44)、父母调整(d=0.27)和 Coparental 关系(d=0.26)的总体效应大小显著,但研究人员观察到的父母行为没有显著变化。有强有力的证据表明,第 4 级 SSTP 是一种有效的干预措施,可改善有临床显著问题的残疾儿童家庭的儿童和家长结局。对于有局限性困难的病例,较不集中的 SSTP 干预措施产生的治疗效果较少,而且这种干预措施的研究相对较少。