Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-24T12:10:34.542Z Has data issue: false hasContentIssue false
  • English
  • Français

Stepping Stones Triple P and Acceptance and Commitment Therapy for Parents of Children with Cerebral Palsy: Trial Protocol

Published online by Cambridge University Press:  28 August 2013

Koa Whittingham ,
Matthew Sanders ,
Lynne McKinlay  and
Roslyn N. Boyd
Koa Whittingham*
Affiliation:
Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Australia
Matthew Sanders
Affiliation:
Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, Australia
Lynne McKinlay
Affiliation:
Queensland Paediatric Rehabilitation Service, Royal Children's Hospital, Brisbane, Australia
Roslyn N. Boyd
Affiliation:
Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
*
Address for correspondence: Dr Koa Whittingham, Queensland Cerebral Palsy and Rehabilitation Research Centre, Level 7, Block 6, RBWH Herston, Brisbane, 4029, Australia. E-mail: [email protected]
Get access

Abstract

This project aims to optimise outcomes for children with cerebral palsy (CP) and their families by testing the efficacy of two complementary interventions novel to the CP population: (1) parenting intervention (Stepping Stones Triple P, SSTP); and (2) parental stress management (Acceptance and Commitment Therapy, ACT) tailored for parents of children with CP. The efficacy of SSTP and the additional effects of ACT will be tested in a wait-list randomised controlled trial, with parents of children with CP (N = 110) randomised into three groups; SSTP, SSTP + ACT and wait-list control. Intervention delivery will combine group sessions with phone consultations. Outcomes will be assessed post-intervention with retention of effect examined at 6-month follow-up. Child outcomes will include: externalising behaviour (primary child outcome), functional performance, parent-reported child quality of life; and parent outcomes will include: dysfunctional parenting (primary parent outcome), parental confidence in performing disability-related parenting practices, degree of problems in performing disability-related parenting practices, parental adjustment, psychological flexibility and parental attitude to child emotions. The theoretical background, study design and study procedures are discussed. The validation of a parenting intervention and a parenting stress intervention for parents of children with CP is crucial to better support parents of children with CP in their parenting role and in providing evidence-based intervention for behavioural and emotional problems in children with CP.

Keywords

parentingbehavioural family interventioncerebral palsyacceptance and commitment therapymindfulness
Type
Controlled Trial Forum
Information
Brain Impairment , Volume 14 , Issue 2 , September 2013 , pp. 270 - 280
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Access Economics. (2007). The economic impact of cerebral palsy in Australia in 2007. Report for Cerebral Palsy Australia, July.Google Scholar
Aran, A., Shalev, R.S., Biran, G., & Gross-Tsur, V. (2007). Parenting style impacts on quality of life in children with cerebral palsy. Journal of Pediatrics, 151 (1), 56–60.CrossRefGoogle ScholarPubMed
Arnold, D.S., O'Leary, S.G., Wolff, L.S., & Acker, M.M. (1993). The Parenting Scale: A measure of dysfunctional parenting in discipline situations. Psychological Assessment, 5, 137–144.CrossRefGoogle Scholar
Australian and New Zealand Perinatal Societies. (1995). The origins of cerebral palsy – a consensus statement. Medical Journal of Australia, 162 (2), 85–90.CrossRefGoogle Scholar
Barlow, J.H., Cullen-Powell, L.A., & Cheshire, A. (2006). Psychological well-being among mothers of children with cerebral palsy. Early Child Development and Care, 176 (3–4), 421–428.CrossRefGoogle Scholar
Boggs, S., Eyberg, S., & Reynolds, L. (1990). Concurrent validity of the Eyberg child behavior inventory. Journal of Clinical Child & Adolescent Psychology, 19 (1), 75–78.CrossRefGoogle Scholar
Brown, T.A., Chorpita, B.F., Korotitsch, W., & Barlow, D.H. (1997). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour Research and Therapy, 35 (1), 79–89.CrossRefGoogle ScholarPubMed
Carlsson, M., Olsson, I., Hagberg, G., & Beckung, E. (2008). Behaviour in children with cerebral palsy with and without epilepsy. Developmental Medicine & Child Neurology, 50 (10), 784–789.CrossRefGoogle ScholarPubMed
de Graaf, I., Speetjens, P., Smit, F., de Wolff, M., & Tavecchio, L. (2008a). Effectiveness of the triple P positive parenting program on behavioral problems in children: A meta-analysis. Behavior Modification, 32 (5), 714–735.CrossRefGoogle ScholarPubMed
de Graaf, I., Speetjens, P., Smit, F., de Wolff, M., & Tavecchio, L. (2008b). Effectiveness of the Triple P Positive Parenting Program on parenting: A meta-analysis. Family Relations, 57 (5), 553–566.CrossRefGoogle Scholar
Dishion, T.J., Patterson, G.R., & Kavanagh, K.A. (1992). An experimental test of the coercion model: Linking theory, measurement, and intervention. In Joan, M. (Ed.), Preventing antisocial behavior: interventions from birth through adolescence (pp. 253–282). New York: Guiliford Press.Google Scholar
Eakes, G.G., Burke, M.L., & Hainsworth, M.A. (1998). Middle-range theory of chronic sorrow. IMAGE: Journal of Nursing Scholarship, 30 (2), 179–184.Google ScholarPubMed
Einfeld, S.L., & Tonge, J. (1996). Population prevalence of psychopathology in children and adolescents with intellectual disability: I. Rationale and methods. Journal of Intellectual Disability Research, 40 (2), 91–98.CrossRefGoogle ScholarPubMed
Eyberg, S., & Ross, A. (1978). Assessment of child behavior problems: The validation of a new inventory. Journal of Clinical Child & Adolescent Psychology, 7 (2), 113–116.CrossRefGoogle Scholar
Eyberg, S. M., & Pincus, D. (1999). Eyberg Child Behavior Inventory and Sutter–Eyberg Student Behaviour Inventory – Revised: Professional manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 38 (5), 581–586.CrossRefGoogle ScholarPubMed
Goodman, R., & Scott, S. (1999). Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is small beautiful? Journal of Abnormal Child Psychology, 27 (1), 17–24.CrossRefGoogle ScholarPubMed
Halberstadt, A.G., Dunsmore, J.D., McElwain, N.M., Eaton, K.L., & McCool, A. (2001). Parents’ beliefs about negative emotions [unpublished questionnaire]. North Carolina State University.Google Scholar
Halberstadt, A.G., Thompson, J.A., Parker, A.E., & Dunsmore, J.D. (2008). Parents’ emotion-related beliefs and behaviours in relation to children's coping with the 11 September 2001 terrorist attacks. Infant and Child Development, 17, 557–580.CrossRefGoogle Scholar
Haley, S.M., Coster, W.J., Ludlow, L.H., Haltiwanger, J.T., & Andrellos, P.J. (1992). Pediatric Evaluation of Disability Inventory: Standardization and administration manual. Boston, MA: Trustee of Boston University.Google Scholar
Hayes, S.C., Strosal, K.D., & Wilson, K.G. (2003). Acceptance and Commitment Therapy: an experiential approach to behavior change. New York: Guilford Press.Google Scholar
Hincliffe, A. (2007). Children with cerebral palsy: A manual for therapists, parents and community workers. Thousand Oaks: Sage Publications.CrossRefGoogle Scholar
Katz, L.F., Wilson, B., & Gottman, J.M. (1999). Meta-emotion philosophy and family adjustment: making an emotional connection. In Katz, L.F., Wilson, B., Gottman, J.M. & Cox, M.J. (Eds.), Conflict and cohesion in families: causes and consequences (pp. 131–165). Mahwah, NJ: Lawrence Erlbaum Associates Publishers.Google Scholar
Kazdin, A.E. (1997). Parent management training: Evidence, outcomes, and issues. Journal of the American Academy of Child & Adolescent Psychiatry, 36 (10), 1349–1356.CrossRefGoogle ScholarPubMed
Ketelaar, M., Volman, M.J.M., Gorter, J.W., & Vermeer, A. (2008). Stress in parents of children with cerebral palsy: What sources of stress are we talking about? Child: Care, Health and Development, 34 (6), 825–829.CrossRefGoogle ScholarPubMed
Landry, S.H., Smith, K.E., & Swank, P.R. (2006). Responsive parenting: establishing early foundations for social, communication and independent problem-solving skills. Developmental Psychology, 42 (4), 627–642.CrossRefGoogle ScholarPubMed
Lloyd, T., & Hastings, R.P. (2008). Psychological correlates of adjustment in mothers of children with intellectual disabilities: cross-sectional and longitudinal relationships. Journal of Intellectual Disability Research, 51 (1), 47–48.Google Scholar
Lovibond, P.E., & Lovibond, S.H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behavior Research and Therapy, 33 (3), 335–343.CrossRefGoogle ScholarPubMed
Nowak, C., & Heinrichs, N. (2008). A comprehensive meta-analysis of Triple P-Positive Parenting Program using hierarchical linear modeling: Effectiveness and moderating variables. Clinical Child and Family Psychology Review, 11 (3), 114–144.CrossRefGoogle ScholarPubMed
O'Dell, S. (1974). Training parents in behavior modification: A review. Psychological Bulletin, 81 (7), 418–433.CrossRefGoogle ScholarPubMed
Palisano, R. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine Child Neurology, 39, 214–223.CrossRefGoogle ScholarPubMed
Parkes, J., McCullough, N., Madden, A., & McCahey, E. (2009a). The health of children with cerebral palsy and stress in their parents. Journal of Advanced Nursing, 65 (11), 2311–2323.CrossRefGoogle ScholarPubMed
Parkes, J., White-Koning, M., McCullough, N., & Colver, A. (2009b). Psychological problems in children with hemiplegia: a European multicentre survey. Archives of Disease in Childhood, 94 (6), 429–433.CrossRefGoogle ScholarPubMed
Parkes, J., White-Koning, M., O'Dickinson, H., Thyen, U., Arnaud, C., Beckung, E., . . . Colver, A. (2008). Psychological problems in children with cerebral palsy: a cross-sectional European study. Journal of Child Psychology and Psychiatry, 49 (4), 405–413.CrossRefGoogle ScholarPubMed
Patterson, G.R. (1982). Coercive family process (Vol. 3). Oregon: Castalia publishing company.Google Scholar
Rentinck, I.C.M., Ketelaar, M., Jongmans, M.J., & Gorter, J.W. (2007). Parents of children with cerebral palsy: A review of factors related to the process of adaptation. Child: Care, Health and Development, 33 (2), 161–169.CrossRefGoogle Scholar
Roberts, C., Mazzucchelli, T., Studman, L., & Sanders, M.R. (2006). Behavioral family intervention for children with developmental disabilities and behavioral problems. Journal of Clinical Child & Adolescent Psychology, 35 (2), 180–193.CrossRefGoogle ScholarPubMed
Robinson, E., Eyberg, S., & Ross, A. (1980). The standardization of an inventory of child conduct problem behaviors. Journal of Clinical Child & Adolescent Psychology, 9 (1), 22–28.CrossRefGoogle Scholar
Rosenbaum, P. (2003). Cerebral palsy: What parents and doctors want to know. British Medical Journal, 326, 970–974.CrossRefGoogle ScholarPubMed
Sanders, M.R., & Christensen, A.P. (1985). A comparison of the effects of child management and planned activities training in five parenting environments. Journal of Abnormal Child Psychology, 13 (1), 101–117.CrossRefGoogle ScholarPubMed
Sanders, M.R., & Dadds, M.R. (1993). Behavioural family intervention. Boston: Allyn and Bacon.Google Scholar
Sanders, M.R., Mazzucchelli, T.G., & Studman, L.J. (2004). Stepping Stones Triple P: The theoretical basis and development of an evidence-based positive parenting program for families with a child who has a disability. Journal of Intellectual and Developmental Disability, 29 (3), 265–283.CrossRefGoogle Scholar
Sanders, M.R., Mazzucchelli, T.G., & Studman, L.J. (2009). Facilitator's manual for Group Stepping Stones Triple P for families with a child who has a disability. Brisbane: Triple P International.Google Scholar
Sanders, M.R., Waugh, L.M., Tully, L.A., & Hynes, K. (1996). The revised family observation schedule. Brisbane: Parenting and Family Support Centre.Google Scholar
Sawyer, M.G., Bittman, M., La Greca, A.M., Crettenden, A.D., Borojevic, N., Raghavendra, P., & Russo, R. (2011). Time demands of caring for children with cerebral palsy: what are the implications for maternal mental health? Developmental Medicine and Child Neurology, 52 (4), 338–343.CrossRefGoogle Scholar
Singh, N.N., Lancioni, G.E., Winton, A.S.W., Fisher, B.C., , Wahler, R.G., McAleaney, K., . . . Sabaawi, M. (2006). Mindful parenting decreases aggression, non-compliance and self-injury in children with autism. Journal of Emotional and Behavioural Disorders, 14 (3), 169–177.CrossRefGoogle Scholar
Singh, N.N., Lancioni, G.E., Winton, A.S.W., Singh, J., Curtis, W.J., Wahler, R.G., & McAleaney, K.M. (2007). Mindful parenting decreases aggression and increase social behaviour in children with developmental disabilities. Behaviour Modification, 31 (6), 749–771.CrossRefGoogle ScholarPubMed
Thomas, R., & Zimmer-Gembeck, M. J. (2007). Behavioral outcomes of Parent–Child Interaction Therapy and Triple P-Positive Parenting Program: A review and meta-analysis. Journal of Abnormal Child Psychology, 35 (3), 475–495.CrossRefGoogle Scholar
Waters, E., Davies, E., Mackinnon, A., Boyd, R., Graham, H.K., Kai Lo, S., . . . Reddihough, D. (2007). Psychometric properties of the quality of life questionnaire for children with cerebral palsy. Developmental Medicine and Child Neurology, 49, 49–55.CrossRefGoogle Scholar
Whittingham, K., Sheffield, J., & Sofronoff, K. (2010). Stress management for parents: Acceptance and commitment therapy [unpublished manuscript]. University of Queensland, Brisbane.Google Scholar
Whittingham, K., Sofronoff, K., Sheffield, J., & Sanders, M.R. (2009). Stepping Stones Triple P: An RCT of a parenting program with parents of a child diagnosed with an autism spectrum disorder. Journal of Abnormal Child Psychology, 37 (4), 469–480.CrossRefGoogle Scholar
Whittingham, K., Wee, D., & Boyd, R. (2011a). Systematic review of the efficacy of parenting interventions for children with cerebral palsy. Child: Care, Health and Development, 37 (4), 475–483.CrossRefGoogle ScholarPubMed
Whittingham, K., Wee, D., Sanders, M.R., & Boyd, R. (2011b). Responding to the challenges of parenting a child with cerebral palsy: a focus group. Disability and Rehabilitation, 32, 1673–1677.Google Scholar
Whittingham, K., Wee, D., Sanders, M., & Boyd, R. (2013). Predictors of psychological adjustment, experienced parenting burden and chronic sorrow symptoms in parents of children with cerebral palsy. Child: Care, Health and Development, 39 (3), 366–373.CrossRefGoogle ScholarPubMed