Salta al menu principale di navigazione Salta al contenuto principale Salta al piè di pagina del sito

Sez. generale - Studi e ricerche

N. 46 (2020)

Fattori predittivi del drop-out: accettabilità e impegno nel parent training

DOI
https://doi.org/10.3280/qpc46-2020oa10163
Inviata
20 July 2020
Pubblicato
20-07-2020

Abstract

L’obiettivo di questa revisione è identificare metodi efficaci per migliorare l’impegno e l’adesione delle famiglie ai programmi di parent training (BPT). Nonostante la letteratura indichi risultati positivi, spesso le famiglie mostrano uno scarso impegno, fino a giungere a un precoce abbandono del percorso terapeutico. Ciò comporta una serie di conseguenze negative per le famiglie, i clinici, la ricerca e il servizio sanitario nazionale. La letteratura, ad oggi, individua alcuni fattori predittivi del drop-out e varie componenti da includere nei parent training per aumentare l’impegno e l’adesione alle procedure di intervento. Tra strategie di coinvolgimento, alcuni autori suggeriscono l’utilizzo di un promemoria degli appuntamenti,
brevi discussioni iniziali sulla necessità di impegnarsi, metodi di coinvolgimento dei sistemi familiari, adattamenti strutturali del programma, incentivi finanziari, aumento del supporto familiare e colloqui motivazionali. Nonostante i programmi BPT abbiano un’elevata efficacia nel cambiamento del comportamento genitoriale, la letteratura evidenzia elevati livelli di drop-out, ragion per cui gli studi presentati hanno piccoli campioni che limitano il potere statistico e la generalizzabilità dei risultati.

Riferimenti bibliografici

  1. Ajzen I., Fishbein M. (1975). Understanding attitudes and predicting social behavior. New Jersey: Prentice Hall.
  2. Armbruster P., Kazdin A.E. (1994). Attrition in child psychotherapy. Advances in Clinical Child Psychology, 16: 81-109.
  3. Baldini F. (2004). Homework, un’antologia di prescrizioni terapeutiche. Milano: Mc Graw-Hill.
  4. Bandura A., Walters R.H. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice-Hall.
  5. Barile I., Berardi S., Flego M., Giuliano R., Zelger S., Bordon E., Pavan E. (2004). Parent training: programmi di formazione per genitori. FIR – Famiglia Interdiscipinarietà e Ricerca, IX, 1: 157-178.
  6. Battagliese G., Caccetta M., Luppino O.I., Baglioni C., Cardi V., Mancini M., Buonanno C. (2015). Cognitive-behavioral therapy for externalizing disorders: A meta-analysis of treatment effectiveness. Behaviour Research and Therapy, 75: 60-71. doi: 10.1016/j.brat.2015.10.008.
  7. Becker K.D., Lee B.R., Daleiden E.L., Lindsey M., Brandt N.E., Chorpita B.F. (2015). The common elements of engagement in children’s mental health services: Which elements for which outcomes? Journal of Clinical Child & Adolescent Psychology, 44(1): 1-14. doi: 10.1080/15374416.2013.814543.
  8. Beeber L.S., Cooper C., Van Noy B.E., Schwartz T.A., Blanchard H.C., Canuso R. (2007). Flying under the radar: Engagement and retention of depressed lowincome mothers in a mental health intervention. Advances in Nursing Science, 30: 221-234. doi: 10.1097/NNR.0B013E31828324C2.
  9. Berne E. (1971). Analisi transazionale e psicoterapia. Roma: Astrolabio.
  10. Broidy L.M., Nagin D.S., Tremblay R.E., Bates J.E., Brame B., Dodge K.A. (2003). Developmental trajectories of childhood disruptive behaviors and adolescent delinquency: A six-site, cross-national study. Developmental Psychology, 39: 222-245. doi: 10.1037/0012-1649.39.2.222.
  11. Cedar B., Levant R.F. (1990). A meta-analysis of the effects of Parent Effectiveness Training. American Journal of Family Therapy, 18(4): 373-384. doi: 10.1080/01926189008250986.
  12. Chacko A., Jensen S.A., Lowry L.S., Cornwell M., Chimklis A., Chan E., Lee D., Pulgarin B. (2016). Engagement in Behavioral Parent Training: Review of the Literature and Implications for Practice. Clin. Child Fam. Psychol. Rev. doi: 10.1007/s10567-016-0205-2.
  13. Coatsworth J.D., Santisteban D.A., McBride C.K., Szapocznik J. (2001). Brief strategic family therapy versus community control: Engagement, retention, and an exploration of the moderating role of adolescent symptom severity. Family Process, 40: 313-331. doi: 10.1111/j.1545-5300.2001.4030100313.x.
  14. Cunningham C.E., Bremner R., Boyle M. (1995). Large group community-based parenting for families of preschoolers at risk for disruptive behaviour disorders: Utilization, cost effectiveness, and outcome. Journal of Child Psychology and Psychiatry, 36: 1141-1159. doi: 10.1111/j.1469-7610.1995.tb01362.x.
  15. Dane A.V., Schneider B.H. (1998). Program integrity in primary and early secondary prevention: Are implementation effects out of control. Clinical Psychology Review, 18(1): 23-45. doi: 10.1016/s0272-7358(97)00043-3.
  16. Domitrovich C E., Greenberg M.T. (2000). The study of implementation: Current findings from effective programs that prevent mental disorders in school-aged children. Journal of Educational and Psychological Consultation, 11(2): 193-221. doi: 10.1207/S1532768XJEPC1102_04.
  17. Dumas J., Nissley-Tsiopinis J., Moreland A. (2007). From intent to enrollment, attendance, and participation in preventive parenting groups. Journal of Child and Family Studies, 16(1): 1-26. doi: 10.1007/s10826-006-9042-0.
  18. Eisner M., Meidert U. (2011). Stages of Parental Engagement in a Universal Parent Training Program. Primary Prevent, 32: 83-93. doi: 10.1007/s10935-011-0238-8.
  19. Eyberg S.M., Edwards D., Boggs S.R., Foote R. (1998). Maintaining the treatment effects of parent training: The role of booster sessions and other maintenance strategies. Clinical Psychology Science and Practice, 5: 544-554. doi: 10.1111/j.1468-2850.1998.tb00173.x.
  20. Farrington D.P., Joliffe D., Hawkins J.D., Catalano R.F., Hill K.G., Kosterman R. (2003). Comparing delinquency careers in court records and self-reports. Criminology, 41: 933-958. doi: 10.1111/j.1745-9125.2003.tb01009.x.
  21. Garvey C., Julion W., Fogg L., Kratovil A., Gross D. (2006), Measuring participation in a prevention trial with parents of young children. Research in Nursing and Health, 29: 212-222. doi: 10.1002/nur.20127.
  22. Gomby D.S. (2000). Promise and limitations of home visitation. JAMA: Journal of the American Medical Association, 284(11): 1430-1431. doi: 10.1001/jama.284.11.1430.
  23. Gordon T. (1997). Genitori efficaci. Educare figli responsabili. Bari: La Meridiana.
  24. Gross D., Julion W., Fogg L. (2001). What motivates participation and dropout among low-income urban families of color in a prevention intervention? Family Relations, 50(3): 246-254. doi: 10.1111/j.1741-3729.2001.00246.x.
  25. Grote N.K., Swartz H.A., Zuckoff A. (2008). Enhancing interpersonal psychotherapy for mothers and expectant mothers on low incomes: Adaptations and additions. Journal of Contemporary Psychotherapy, 38: 23-33. doi: 10.1007/s10879-007-9065-x.
  26. Grote N.K., Swarz H.A., Geibel S.L., Zuckoff A., Houck P.R., Frank E. (2009). A randomized controlled trial of culturally relevant, brief interpersonal psychotherapy for perinatal depression. Psychiatric Services, 60: 313-321. doi: 10.1176/appi.ps.60.3.313.
  27. Grote N.K., Zuckoff A., Swarz H., Bledsoe S.E., Geibel S. (2007). Engaging women who are depressed and economically disadvantaged in mental health treatment. Social Work, 52: 295-308. doi: 10.1093/sw/52.4.295.
  28. Hanf C. (1970). Shaping mothers to shape their children’s behavior. Unpublished manuscript, University of Oregon Medical School.
  29. Heinrichs N. (2006). The effects of two different incentives on recruitment rates of families into a prevention program. Journal of Primary Prevention, 27: 345-365. doi: 10.1007/s10935-006-0038-8.
  30. Ingoldsby E.M. (2011). Review of Interventions to Improve Family Engagement and Retention in Parent and Child Mental Health Programs. J. Child Fam. Stud., Author manuscript; available in PMC 2011 Oct 1. Published in final edited form as: J. Child Fam. Stud., 2010, Oct 1; 19(5): 629-645. doi: 10.1007/s10826-009-9350-2.
  31. Kaminski J.W., Valle L.A., Filene J.H., Boyle C.L. (2008). A meta-analytic review of components associated with parent training program effectiveness. Journal of Abnormal Child Psychology, 18: 373-384. doi: 10.1007/s10802-007-9201-9.
  32. Kazdin A.E., Holland L., Crowley M. (1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting and Clinical Psychology, 65(3): 453-463. doi: 10.1037/0022-006X.65.3.453.
  33. Kazdin A.E., Whitely M.K. (2003). Treatment of parental stress to enhance therapeutic change among children referred for aggressive and antisocial behavior. Journal of Consulting and Clinical Psychology, 71: 504-515. doi: 10.1037/0022-006x.71.3.504.
  34. Kazdin A.E., Wassell G. (2000a). Predictors of barriers to treatment and therapeutic change in outpatient therapy for antisocial children and their families. Mental Health Services Research, 2: 27-40. doi: 10.1023/a:1010191807861.
  35. Lambert M.J., Michael J., Hansen N.B., Finch A.E. (2001). Patient-focused research: Using patient outcome data to enhance treatment effects. Journal of Consulting and Clinical Psychology, 69(2): 159-172. doi: 10.1037/0022-006X.69.2.159.
  36. Lambruschi F. (2004). Psicoterapia cognitiva dell’età evolutiva. Procedure di assessment e strategie psicoterapeutiche. In: Manuali di psicologia, psichiatria e psicoterapia. Torino: Bollati Boringhieri.
  37. Lambruschi F., Muratori M. (2013). Psicopatologia e psicoterapia dei disturbi della condotta. Roma: Carocci.
  38. Lochman J., Wells K., Lenhart L.A. (2012). Coping Power. Programma per il controllo della rabbia e aggressività in bambini e adolescenti. Trento: Erickson.
  39. Masi M.V., Miller R.B., Olson M.M. (2003). Differences in dropout rates among individual, couple, and family therapy clients. Contemporary Family Therapy: An International Journal, 25(1): 63-75. doi: 10.1023/A:1022558021512.
  40. McCurdy K., Daro D. (2001). Parent involvement in family support programs: An integrated theory. Family Relations, 50(2): 113-121. doi: 10.1111/j.1741-3729.2001.00113.x.
  41. McKay M., Nudelman R., McCadam K. (1996b). Involving inner-city families in mental health services: First interview engagement skills. Research on Social Work Practice, 6: 462-472. doi: 10.1177/104973159600600404.
  42. Miller G.E., Prinz R.J. (2003). Engagement of families in treatment for childhood conduct problems. Behavior Therapy, 34: 517-534. doi: 10.1016/S0005-7894(03)80033-3.
  43. Miller W.R., Rollnick A. (eds.) (2002). Motivational interviewing:Preparing people for change (2nd ed.). New York: Guilford Press.
  44. Moffitt T.E., Caspi A. (2001). Childhood predictors differentiate life-course persistent and adolescence-limited antisocial pathways among males and females. Development and Psychopathology, 13: 355-375. doi: 10.1017/S0954579401002097.
  45. Moffitt T.E., Caspi A., Harrington H., Milne B.J. (2002). Males on the life-course persistent and adolescence-limited antisocial pathways: Follow-up at age 26 years. Development and Psychopathology, 14: 179-207. doi: 10.1017/s0954579402001104.
  46. Moncher F.J., Prinz R.J. (1991). Treatment fidelity in outcome studies. Clinical Psychology Review, 11(3): 247-266. doi: 10.1016/0272-7358(91)90103-2.
  47. Morrissey-Kane E., Prinz R.J. (1999). Engagement in child and adolescent treatment: The role of parental cognitions and attributions. Clinical Child and Family Psychology Review, 2: 183-198. doi: 10.1023/A:1021807106455.
  48. Mowbray C.T., Holter M.C., Teague G.B., Bybee D. (2003). Fidelity criteria: Development, measurement, and validation. American Journal of Evaluation, 24(3): 315-340. doi: 10.1177/109821400302400303.
  49. National Institute of Mental Health (2001). DHHS Publication No. CG 031-591. Washington, DC: US Government Printing Office. Blueprint for change: Research on Child and Adolescent Mental Health’s Council’s Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment.
  50. Nock M.K., Kazdin A. E., Matthew K., Alan E. (2005). Randomized controlled trial of a brief intervention for increasing participation in parent management training. Journal of Consulting and Clinical Psychology, 73(5): 872-879. doi: 10.1037/0022-006X.73.5.872.
  51. Nock M.K., Kazdin A.E. (2001). Parent expectancies for child therapy: Assessment and relation to participation in treatment. Journal of Child and Family Studies, 10:155-180. doi: 10.1023/A:1016699424731.
  52. Olzbek A., Ozlem G., Mustan A.T. (2018). Which parents dropout from an evidence-based parenting programme (Triple-P) at CAMHS? Comparison of programme-completing and dropout parents. Clinical Child Psychology and Psychiatry, 24(1). doi: 10.1177/1359104518792294.
  53. Pekarik G., Stephenson L.A. (1988). Adult and child client differences in therapy dropout research. Journal of Clinical Child Psychology, 17(4): 316-321. doi: 10.1207/s15374424jccp1704_3.
  54. Pezzica S., Bertini N., Millepiedi S., Masi G. (2008). Gruppi di Parent Training per genitori e bambini con Disturbo da Deficit di Attenzione/Iperattività e Disturbo Oppositivo Provocatorio. Un’esperienza integrata. Psychology Published. doi: 10.1449/26789.
  55. Prinz R.J., Miller G.E. (1994). Family-based treatment for childhood antisocial behavior: Experimental influence on dropout and engagement. Journal of Consulting and Clinical Psychology, 62: 645-650. doi: 10.1037/0022-006X.62.3.645.
  56. Prochaska J.O., Velicer W.F. (1997). The Transtheoretical Model of health behavior change. American Journal of Health Promotion, 12: 38-48. doi: 10.4278/0890-1171-12.1.38.
  57. Reyno S.M., McGrath P.J. (2006). Predictors of parent training efficacy for child externalizing behavior problems – A meta-analytic review. Journal of Child Psychology and Psychiatry, 47, 1: 99-111. doi: 10.1111/j.1469-7610.2005.01544.
  58. Rogers T.R., Forehand R., Griest D.L., Wells K.C., McMahon R.J. (1981). Socioeconomic status: Effects on parent and child behaviors and treatment outcome of parent training. Journal of Clinical Child Psychology, 10: 98-101. doi: 10.1080/15374418109533024.
  59. Ryan R.M., Deci E.L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55: 68-78. doi: 10.1037/0003-066X.55.1.68.
  60. Santisteban D.A., Szapocznik J., Perez-Vidal A., Kurtines W.M., Murray E.J., LaPerriere A. (1996). Efficacy of intervention for engaging youth and families into treatment and some variables that may contribute to differential effectiveness. Journal of Family Psychology, 10(1): 35-44. doi: 10.1037/0893-3200.10.1.35.
  61. Scabini E., Iafrate R. (2003). Psicologia dei legami familiari. Bologna: il Mulino.
  62. Snell-Johns J., Mendez J.L., Smith B.H. (2004). Evidence-Based Solutions for Overcoming Access Barriers, Decreasing Attrition, and Promoting Change With Underserved Families. Journal of Family Psychology, 18(1): 19-35. doi: 10.1037/0893-3200.18.1.19.
  63. Spoth R., Redmond C. (1995). Parent motivation to enroll in parenting skills programs: A model of family context and health belief predictors. Journal of Family Psychology, 9: 294-310. doi: 10.1037/0893-3200.9.3.294.
  64. Spoth R., Redmond C. (2000). Research on family engagement in preventive interventions: Toward improved use of scientific findings in primary prevention practice. Journal of Primary Prevention, 21: 267-284. doi: 10.1023/A:1007039421026.
  65. Staudt M. (2007). Treatment engagement with caregivers of at-risk children: Gaps in research and conceptualization. Journal of Child and Family Studies, 16: 183-196. doi: 10.1007/s10826-006-9077-2.
  66. Stern S.B., Azar S.T. (1998). Integrating cognitive strategies into behavioral treatment for abusive parents and families with aggressive adolescents. Clinical Child Psychology and Psychiatry, 3(3): 387-403. doi: 10.1177/1359104598033005.
  67. Stevens J., Kelleher K.J., Ward-Estes J., Hayes J. (2006). Perceived barriers to treatment and psychotherapy attendance in child community mental health centers. Community Mental Health Journal, 42(5): 449-58. doi: 10.1007/s10597-006-9048-5.
  68. Swarikars V., Dadds M. (2017). What Role for Parental Attributions in Parenting Interventions for Child Conduct Problems? Advances from Research into Practice. Clinical Child and Family Psychology Review, September. doi: 10.1007/s10567-017-0243-4.
  69. Swarz H.A., Zuckoff A., Grote N.K., Spielvogle H.N., Bledsoe S.E., Shear M.K. (2007). Engaging depressed patients in psychotherapy: Integrating techniques from motivational interviewing and ethnographic interviewing to improve treatment participation. Professional Psychology: Research in Practice, 38(4): 430-439. doi: 10.1037/0735-7028.38.4.430.
  70. Szapocznik J., Perez-Vidal A., Brickman A., Foote F. H., Santisteban D., Hervis O., Kurtines W.M. (1988). Engaging adolescent drug abusers and their families in treatment: A strategic structural systems approach. Journal of Consulting and Clinical Psychology, 56(4): 552-557. doi: 10.1037/0022-006X.56.4.552.
  71. 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. Abnorm. Child Psychol., 35(3): 475-95. doi: 10.1007/s10802-007-9104-9.
  72. Thompson S.J., Bender K., Lantry J., Flynn P.M. (2007). Treatment engagement: Building therapeutic alliance in home-based treatment with adolescents and their families. Contemporary Family Therapy, 29: 39-55. doi: 10.1007/s10591-007-9030-6.
  73. Watts B.D., Dadds M.R. (2007). Facilitating treatment attendance in child and adolescent mental health services: A community study. Clinical Child Psychology and Psychiatry, 12(1): 105-116. doi: 10.1177/1359104507071089.
  74. Webster Stratton C., Herbert M. (1994). Troubled family – Problem children. Chichester, UK: Wiley.

Metriche

Caricamento metriche ...