School of Lifespan Development and Educational Sciences, Kent State University.
Department of Psychology, University of North Texas.
J Fam Psychol. 2018 Sep;32(6):816-827. doi: 10.1037/fam0000457.
Despite the rising cultural phenomenon of grandparents parenting grandchildren on a full-time basis due to problems within the birth parent generation, intervention studies with these families have been scarce, methodologically flawed, and without conceptual underpinnings. We conducted a randomized clinical trial (RCT) with 343 custodial grandmothers recruited from across 4 states to compare the effectiveness of behavioral parent training (BPT), cognitive-behavioral therapy (CBT), and information-only control (IOC) conditions at lowering grandmothers' psychological distress, improving their parenting practices, and reducing the internalizing and externalizing difficulties of target grandchildren between ages 4 and 12. These outcomes were derived conceptually from the family stress model and modeled as latent constructs with multiple indicators. Each RCT condition was fully manualized and delivered across 10 sessions within groups led jointly by trained professionals and peer facilitators in community settings. Multidomain second-order latent difference score models were performed on a full intent-to-treat basis to compare the 3 RCT conditions on changes in the above outcomes from baseline to postintervention and from baseline to 6 months postintervention. In general, while CBT and BPT interventions were both superior to IOC at both times of measurement on most outcomes, they differed little from each other. Effect sizes were generally in the moderate to large range and similar to those found in prior studies of BPT and CBT with traditional birth parents. We conclude from this research that evidence-based interventions focusing on appropriate skill development and behavioral change can yield positive outcomes within custodial grandfamilies. (PsycINFO Database Record
尽管由于生育父母一代存在问题，全职由祖父母照顾孙辈的文化现象日益增多，但针对这些家庭的干预研究却很少，方法上存在缺陷，而且没有概念基础。我们对来自 4 个州的 343 位监护祖母进行了一项随机临床试验 (RCT)，以比较行为父母培训 (BPT)、认知行为疗法 (CBT) 和仅信息对照组 (IOC) 在降低祖母心理困扰、改善育儿实践以及减少 4 至 12 岁目标孙辈的内化和外化困难方面的效果。这些结果从家庭压力模型中概念上得出，并作为具有多个指标的潜在结构进行建模。每个 RCT 条件都进行了全面的手册化，并在社区环境中由经过培训的专业人员和同行促进者联合领导的小组中进行了 10 次会议。采用多维二阶潜在差异评分模型对全意向治疗进行分析，以比较 RCT 条件在基线到干预后以及基线到干预后 6 个月的上述结果变化。总的来说，虽然 CBT 和 BPT 干预在大多数结果上都优于 IOC 在两个测量时间点，但它们彼此之间差异不大。效应大小通常处于中等至较大范围，与之前对传统生育父母进行 BPT 和 CBT 的研究中发现的相似。我们从这项研究中得出结论，以适当技能发展和行为改变为重点的循证干预措施可以在监护祖孙家庭中产生积极的结果。
