Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior

A. van Herwaarden; H. Schuiringa; Maroesjka van Nieuwenhuijzen; B. Orobio de Castro; J.E. Lochman; W. Matthys

doi:10.1016/j.ridd.2022.104296

Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior

A. van Herwaarden, H. Schuiringa, Maroesjka van Nieuwenhuijzen, B. Orobio de Castro, J.E. Lochman, W. Matthys

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects.

AIMS: The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF.

METHODS AND PROCEDURES: Seventy-two children (aged 9-18; Mage = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions.

OUTCOMES AND RESULTS: The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002).

CONCLUSIONS AND IMPLICATIONS: The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF.

Original language	English
Article number	104296
Pages (from-to)	1-10
Journal	Research in Developmental Disabilities
Volume	128
DOIs	https://doi.org/10.1016/j.ridd.2022.104296
Publication status	Published - Sept 2022

Bibliographical note

Funding Information:
This study was funded by The Netherlands Organisation for Health Research and Development (ZonMw, Grant number 729101008 ) and The Association of Orthopedagogical Treatment Centres (VOBC-LVG).

Publisher Copyright:
© 2022

Keywords

Humans
Intellectual Disability/psychology
Learning Disabilities
Parent-Child Relations
Problem Behavior
Therapeutic Alliance
Treatment Adherence and Compliance
Treatment adherence
Externalizing problem behavior
Child cognitive behavior therapy
Therapist alliance-building behavior
Behavioral parent training
Mild intellectual disability or borderline intellectual functioning

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van Herwaarden, A., Schuiringa, H., van Nieuwenhuijzen, M., Orobio de Castro, B., Lochman, J. E., & Matthys, W. (2022). Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior. Research in Developmental Disabilities, 128, 1-10. Article 104296. https://doi.org/10.1016/j.ridd.2022.104296

@article{ce68c782e58249d5aa1721018f130b6c,

title = "Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior",

abstract = "BACKGROUND: Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects.AIMS: The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF.METHODS AND PROCEDURES: Seventy-two children (aged 9-18; Mage = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions.OUTCOMES AND RESULTS: The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002).CONCLUSIONS AND IMPLICATIONS: The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF.",

keywords = "Humans, Intellectual Disability/psychology, Learning Disabilities, Parent-Child Relations, Problem Behavior, Therapeutic Alliance, Treatment Adherence and Compliance, Treatment adherence, Externalizing problem behavior, Child cognitive behavior therapy, Therapist alliance-building behavior, Behavioral parent training, Mild intellectual disability or borderline intellectual functioning",

author = "{van Herwaarden}, A. and H. Schuiringa and {van Nieuwenhuijzen}, Maroesjka and {Orobio de Castro}, B. and J.E. Lochman and W. Matthys",

note = "Funding Information: This study was funded by The Netherlands Organisation for Health Research and Development (ZonMw, Grant number 729101008 ) and The Association of Orthopedagogical Treatment Centres (VOBC-LVG). Publisher Copyright: {\textcopyright} 2022",

year = "2022",

month = sep,

doi = "10.1016/j.ridd.2022.104296",

language = "English",

volume = "128",

pages = "1--10",

journal = "Research in Developmental Disabilities",

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van Herwaarden, A, Schuiringa, H, van Nieuwenhuijzen, M, Orobio de Castro, B, Lochman, JE & Matthys, W 2022, 'Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior', Research in Developmental Disabilities, vol. 128, 104296, pp. 1-10. https://doi.org/10.1016/j.ridd.2022.104296

Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior. / van Herwaarden, A.; Schuiringa, H.; van Nieuwenhuijzen, Maroesjka et al.
In: Research in Developmental Disabilities, Vol. 128, 104296, 09.2022, p. 1-10.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior

AU - van Herwaarden, A.

AU - Schuiringa, H.

AU - van Nieuwenhuijzen, Maroesjka

AU - Orobio de Castro, B.

AU - Lochman, J.E.

AU - Matthys, W.

N1 - Funding Information: This study was funded by The Netherlands Organisation for Health Research and Development (ZonMw, Grant number 729101008 ) and The Association of Orthopedagogical Treatment Centres (VOBC-LVG). Publisher Copyright: © 2022

PY - 2022/9

Y1 - 2022/9

N2 - BACKGROUND: Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects.AIMS: The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF.METHODS AND PROCEDURES: Seventy-two children (aged 9-18; Mage = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions.OUTCOMES AND RESULTS: The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002).CONCLUSIONS AND IMPLICATIONS: The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF.

AB - BACKGROUND: Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects.AIMS: The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF.METHODS AND PROCEDURES: Seventy-two children (aged 9-18; Mage = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions.OUTCOMES AND RESULTS: The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002).CONCLUSIONS AND IMPLICATIONS: The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF.

KW - Humans

KW - Intellectual Disability/psychology

KW - Learning Disabilities

KW - Parent-Child Relations

KW - Problem Behavior

KW - Therapeutic Alliance

KW - Treatment Adherence and Compliance

KW - Treatment adherence

KW - Externalizing problem behavior

KW - Child cognitive behavior therapy

KW - Therapist alliance-building behavior

KW - Behavioral parent training

KW - Mild intellectual disability or borderline intellectual functioning

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U2 - 10.1016/j.ridd.2022.104296

DO - 10.1016/j.ridd.2022.104296

M3 - Article

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SN - 0891-4222

VL - 128

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JO - Research in Developmental Disabilities

JF - Research in Developmental Disabilities

M1 - 104296

ER -

van Herwaarden A, Schuiringa H, van Nieuwenhuijzen M, Orobio de Castro B, Lochman JE, Matthys W. Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior. Research in Developmental Disabilities. 2022 Sept;128:1-10. 104296. doi: 10.1016/j.ridd.2022.104296

Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior

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Keywords

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