To test a school-based therapy intervention, McArdle et al. (2002) asked teachers to identify high-risk students in a high unemployment area of North Tyneside, England.
The risk factors included scholastic under-performance, family problems, poor nourishment and care, impaired peer relationships, and behavioral/emotional difficulties. Groups of eight students were then randomly allocated to 12-week programs consisting of either a group therapy condition or a curriculum studies condition.
The group therapy condition combined creative-expressive and psychodrama approaches whereby students first built up mutual trust and then acted out and explored troubling situations that they had encountered. The curriculum studies condition combined individual tutoring and group teaching. Assessment instruments included the YSR and the Multidimensional Self-Concept Scale (MSCS) completed by the participating students; the CBCL completed by their parents; and the TRF completed by their teachers prior to the interventions, immediately following the interventions, and again a year later.
A strong feature of the outcome assessment was that the 1-year follow-up TRFs were completed by different teachers than those who completed the earlier TRFs, because all students had changed teachers and most had changed schools. The teachers who completed the follow-up TRFs were blind as to intervention status. For the 105 students who completed the study, the MSCS and the Internalizing, Externalizing, and Total Problems scores of the YSR and TRF showed significant declines from pre- to post-intervention to follow-up assessments for both the group therapy and curriculum studies conditions.
In addition, the TRF Internalizing, Externalizing, and Total Problems scores showed significant interactions between the three assessment points and the two intervention conditions. These interactions revealed that improvements were significantly greater for the group therapy condition than for the curriculum studies condition. Although self-ratings and teacher ratings both indicated improvements, the TRF scores indicated more improvement in the group therapy than in the curriculum studies condition. McArdle et al. also compared TRF scores before vs. after a 1-term waiting-list control period prior to the beginning of the interventions. No significant changes occurred in TRF Internalizing, Externalizing, or Total Problems scores during the waiting-list period, indicating that neither the passage of time nor repeated ratings by teachers accounted for the improvements found in the post-intervention comparisons.
Furthermore, only students receiving group therapy showed significantly greater improvements from pre- to post-intervention than during the waiting period. The authors concluded that “education and health professionals and managers should consider including group-work-based early interventions in the development of new child health services or in the overall management of behavioral and emotional problems in school” (p. 711).
Reference: McArdle, P., Mosely, D., Quibell, T., Johnson, R., Allen, A., Hammal, D., & leCouteur, A. (2002) School-based indicated prevention: A randomised trial of group therapy. Journal of Child Psychology and Psychiatry, 43, 705-712.