Archives: Intervention

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The aim of the intervention is to increase the adolescents’ social skills, development of moral inference and aggression control. The intervention strengthens emotional regulation and anger management of children and adolescents through practicing of everyday situations.

Description of the intervention

Aggression replacement training (ART) is a group-based intervention targeted for children and adolescents who have problems in managing aggression and emotions. ART lies on the theory of social learning (Bandura 1973), cognitive-behavioral treatment model (Novaco 1975) and the theory of moral development (Kohlberg 1973). The adolescents’ peer groups gather three times a week for ten weeks. Two education, social or health care professionals who have received the ART training, instruct the groups. In the ART-group meetings the focus is on aggression management, moral inference and social skills, and the meetings are structured. The tailored exercises are focused on practicing new skills for daily situations in adolescents’ life. A preventive FamilyTies method for the development of social skills has been developed based on the ART in the Nordic countries.

Availability of the intervention in Finland

Method and instructor training for the intervention is organized by the ART ry. in Finland. The training is targeted at education, social and healthcare professionals, who can integrate the intervention into their own working environment alongside training. Originally, Arnold P. Goldstein with his colleges in the USA, has developed the intervention. In Finland, the intervention has been used in the primary and special services of social and healthcare, but there is no exact information on the regional availability of the ART.

Research- and evidence-based efficacy of the intervention

ART has been studied internationally, for instance in a systematic review (Brännström et al. 2016), in two RCT studies (Coleman, Pfeiffer & Oakland 1992; Jones 1991) and in the Nordic countries in a Norwegian study, which included a control group (Gundersen & Svartdal 2006). Due to some methodological problems the results of the studies could not be interpreted unambiguously. There is no peer reviewed study on the ART in Finland. The intervention has some evidence of effectiveness in terms of improvement of social skills among adolescents in residential care, when compared to the control group.
 

Literature

Bandura, A. (1973). Aggression: A social learning analysis. Englewood Cliffs, NJ: Prentice-Hall.

Brännström L., Kaunitz K., Andershed A-K., Saud S. & Smedslund G. (2016). Aggression replacement training (ART) for reducing antisocial behavior in adolescents and young adults: A systematic review. Aggression and Violent Behavior, 27, 30–41.

Gundersen, K. & Svartdal, F. (2003). Selvrapporteringsskjema [Self-report problem behaviour questionnaire (in Norwegian)]. Nærbø, Norway: Rogaland Høgskole.

Coleman M., Pfeiffer S. & Oakland T. (1992). Aggression replacement training with behaviorally disordered adolescents. Behavioral Disorders, 18, 54–66.

Jones, Y. (1991). Aggression replacement training in a high school setting. Australian Journal of Guidance and Counselling, 1, 1–19.

Kohlberg, L. (1973). Collected papers on moral development and moral education. Cambridge. MA: Harvard University, Center for Moral Education.

Novaco, RW. (1975). Anger control: The development and evaluation of an experimental treatment. Lexington, MA: D.C. Health.

Abstract

Delivery of the intervention

Individual-/family-based

Aim of the intervention

Let´s talk about Children –intervention aims to strengthen the safety in child’s everyday life at home, school and daycare. The intervention enchances parenting, thereby supporting the child’s development and preventing the formation of problems.

Description of the intervention

The intervention is targeted at child families where parent(s) has problems that are reflected in parenting, particularly mental health problems. Let´s talk about Children –discussion is a part of the Effective Child & Family –interventions. Research-based knowledge of the child development and the risk that parent’s mental health problems impose on it have impacted on the development of the intervention (Beardslee & Podorefsky 1988; Beardslee ym. 1997). The Effective Child & Family –interventions are based on the theory of child development as a part of different development environments (Solantaus & Niemelä 2016). The intervention consists of 1–3 meetings with the parents, which are structured and based on the Let´s talk about Children –manual but the contents of the meetings are tailored according to the family’s unique situation. The family situation, the child’s development and strengths as well as the impact of the parent’s mental health problem are discussed thoroughly in the meetings. After the intervention, a Let´s talk about Children conference with the networks around the child is organized, if needed. The intervention has been used in Finland also in early education and in primary school as a method in cooperation between home and school as well as in the child and family work of the Criminal Sanctions Agency.

Availability of the intervention in Finland

Training for the Let´s talk about Children –discussion is a part of the Effective Child & Family method training. The training is targeted at those working with child families, but especially for the social and health care professionals. Material and Let´s talk about Children –discussion manual are included in the training. In Finland, the intervention is used in the primary and secondary social and health care services, early education and primary schools. Exact information on the regional availability of the intervention is not available.

Research- and evidence-based efficacy of the intervention

The intervention has been studied in Finland regarding its applicability to the Finnish service system (Solantaus et al. 2009). There is also a randomized study on the effectiveness of Let´s talk about Children –discussion and –family intervention on children’s emotions and behavior (Punamäki et al. 2013). In the follow-ups of the studies the intervention was found to have positive effects on children, reducing their emotional problems and anxiety and increasing their social behavior. The limitations of the studies have been the drop-outs and reliability (Punamäki et al. 2013) and a missing control group. Furthermore, the effect sizes have not been reported (Solantaus et al. 2009). There is moderate research-based evidence of effectiveness in Finland.

Literature

Beardslee, W. R. & Podorefsky, D. (1988). Resilient adolescents whose parents have serious affective and other psychiatric disorders: Importance of self-understanding and relationships. American Journal of Psychiatry, 145(1), 63–69.

Beardslee, W., Salt, P., Versage, E., Gladstone, T., Wright, E. & Rothberg, P. (1997). Sustained change in parents receiving preventive interventions for families with depression. American Journal of Psychiatry, 154, 510–515.

Punamäki, R-L., Paavonen, J., Toikka, S. & Solantaus, T. (2013). Effectiveness of preventive intervention in improving cognitive attributions among children of depressed parents: A randomized study. Journal of Family Psychology 27, 683–690.

Solantaus, T., Toikka, S., Alasuutari, M., Beardslee, W. R. & Paavonen, E. J. (2009). Safety, feasibility and family experiences of preventive interventions for children and families with parental depression. International Journal of Mental Health Promotion 11, 15–24.

Solantaus, T. & Niemelä, M. (2016). Arki kantaa – kun se pannaan kantamaan. Perheterapia, 1, 21–33.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

ABC for parents aims to strengthen the attachment relationship between the child and the parents, thereby promoting child’s health and psychosocial development. The intervention improves parenting skills.

Description of the intervention

The intervention is delivered in peer groups, is based on research evidence and targeted at parents of 3–12 years old children. ABC for parents -intervention lies on the theory of social learning and on research-based knowledge of child’s psychosocial development. The ABC for parents –groups gather four times every two weeks and once more after 2–3 months after the intervention. The groups are instructed by a professional who has received a specific training for the intervention. A guidebook designed for the intervention guides the meetings and provides a structure for them. The purpose of the group meetings is to practice new parenting skills, coherent parenting and to increase understanding of the importance of the attachment relationship. Each meeting focuses on a pre-determined parenting topic.

Availability of the intervention in Finland

Method training for ABC for parents is organized for the professionals working with child families. In Sweden, Karolinska Institutet and the city of Stockholm co-organize the trainings. The training is available only in Swedish. The intervention was initially developed in co-operation of the psychologists of the Karolinska Institutet and the city of Stockholm. In Finland, The Mannerheim League for Child Welfare has organized method trainings in the capital region.

Research- and evidence-based efficacy of the intervention

The effectiveness of ABC for parents has been tested in a pilot study (Enebrink et al. 2014) and in an RCT-study in Sweden (Ulfsdotter et al. 2014). Despite the methodological challenges the studies have shown positive changes in parents’ perceived self-efficacy in the study group as compared to the control group. Also, the parents in the intervention group (n = 317) observed their children’s health more than the parents in the control group (n = 297) in the 6-month follow up (Ulfsdotter et al. 2014). There is a moderate research-based evidence of effectiveness for the intervention but no peer reviewed research on the intervention in Finland.

Literature

Enebrink, P., Danneman, M., Mattsson, V. B., Ulfsdotter, M., Jalliong, C. & Lindberg, L. (2014). ABC for parents: Pilot study of a universal 4-session program shows increased parenting skills, self-efficacy and child well-being. Journal of Child and Family Studies 24(7), 1917–1931.

Ulfsdotter, M., Enebrink, P. & Lindberg, L. (2014). Effectiveness of a universal health-promoting parenting program: a randomized waitlist-controlled trial of All Children in Focus. BMC Public Health 14, 1083.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The aim of the intervention is, as early prevention, to support children’s school readiness, social and socio-emotional skills and self-regulation.

Description of the intervention

The intervention is group-based and targeted at 3–7 years old children to improve the development of their emotional and problem-solving skills. Second steps is targeted at pre-school children and first year primary school children. Second step early learning -intervention is developed based on the Second Step for 3–5 years old children at the early education. An education professional holds short lessons, which focus on a specific weekly theme. The intervention themes and duration of the lessons vary depending on the children’s age. It is recommended that Second step / Second step early learning –lessons are held in a child group weekly and the intervention includes 22–28 weekly themes. Parents are provided with information about the program and exercises that they can do at home with the child. The home exercises support the Second step early learning / Second step -lessons given at the early education and in primary school, respectively. The intervention has also been applied as a tool in special group therapies.

Availability of the intervention in Finland

Method training for the intervention is aimed at education professionals. In Finland, Hogrefe Publishing Group Oy and Akat Consulting Ab are responsible for the training. The intervention has been adapted from the original US Second step program, which has been developed for the prevention of aggressive and violent behavior of adolescents. The intervention is used in early and primary education in Finland. There is no exact information for the regional availability of the intervention.

Research- and evidence-based efficacy of the intervention

There is abundant international international research on Second Step / Second Step Early Learning –interventions. Effectiveness of the intervention has been studied in a systematic literature review and in a meta-analysis comprising of 24 RCT studies (Moy & Hazen 2018). The meta-analysis showed that the intervention did not effectively increase prosocial behavior or reduce aggressive or unwanted behavior (Moy & Hazen 2018) but it was indirectly related to better preschool readiness (Wenz-Gross et al. 2018). There is moderate research-based evidence of effectiveness of the intervention.

Literature

Moy, G. E. & Hazen, A. (2018). A systematic review of the Second step program. Journal of School Psychology, 71, 18–41.

Wenz-Gross, M., Yoo, Y., Upshur, C.C. & Gambino, A. J. (2018). Pathways to kindergarten readiness: The roles of Second Step Early Learning curriculum and social emotional, executive functioning, preschool academic and task behavior skills. Frontiers in Psychology, 9, 1886.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The aim of the intervention is to increase the child’s skills to identify emotions. The intervention strengthens the child’ ability to discuss and regulate emotions and increases social skills.

Description of the intervention

The Small Group Dinosaur is a structured group-based intervention for children who have behavioral problems and disorders. The framework for the intervention is provided by the attachment relationship and social learning theories, behavioral and solution-focused therapies and the stress management theory. The children’s groups gather weekly for 18-20 weeks. Peer groups for parents are organized simultaneously with the children’s groups (6 children per group). The participants practice interactive exercises in the groups and the children are given homework that they can do together with their parents. The groups are instructed by a social and healthcare or education professional who has received the Small Group Dinosaur training.

Availability of the intervention in Finland

Social and healthcare or education professional can receive a training as a Small Group Dinosaur instructor. In Finland, the trainings are organized by the Research Center for Child Psychiatry at the University of Turku. The intervention is a part of the Incredible Years method family. The incredible Years was originally developed  in the US. In Finland, the intervention has been mosty applied by the education and social sectors in the capital region and in the special healthcare services as a cooperation of the child psychiatry and family health clinics in Helsinki.

Research- and evidence-based efficacy of the intervention

The effectiveness of the intervention has been studied in RCT-studies in the US (Webtster-Stratton & Hammond 1997; Webster-Stratton et al. 2004) and in Norway (Larsson et al. 2009). Those studies indicated that the Small Group Dinosaur has positive effects on reducing behavioral problems and increasing social behavior as well as problem-solving skills among 4- to 9-year-old children as compared to the control group. There is satisfactory research-based evidence for the effectiveness of the intervention.

Literature

Larsson B., Fossum S., Clifford G., Drugli MB., Handegård BH. & Morch W-T. (2009). Treatment of oppositional defiant and conduct problems in young Norwegian children. Results of randomized controlled trial. European Child and Adolescent Psychiatry 18, 42–52.

Webster-Stratton, C. & Hammond M. (1997). Treating children with early-onset conduct problems: A comparison of child and parent training interventions. Journal of Consulting and Clinical Psychology 65, 93–109.

Webster-Stratton, C., Reid, J. & Hammond, M. (2004). Treating children with early-onset conduct problems: Intervention outcomes for parent, child, and teacher training. Journal of Clinical Child and Adolescent Psychiatry 33, 105–124.

Abstract

Delivery of the intervention

Individual-/family-based

Aim of the intervention

The Early Interaction promotion project (European Early Promotion Project) aims to promote the positive early interaction between parents and child. The intervention focuses on identifying the family’s resources and finding solution to potential problems.

Description of the intervention

The Early Interaction promotion project is targeted at child families, especially for families expecting or with a newborn baby. The intervention lies on system theoretic and cognitive-behavioral thinking as well as on research-based knowledge on early identification of psychosocial risk factors. In the Early Interaction promotion project a health care professional working with baby- and child families conducts an interview with a family during the trimester of the pregnancy and after 4-8 weeks of the child birth. The interviews are intended to support the early interaction, survey the family’s need for support and bring up the possible concerns regarding the family situation. The interviews are structured by the Early Interaction promotion project –interview questionnaires, and they are held at the family’s home, if possible. The Early Interaction promotion project is a toolkit for education, social and health care professionals, and it guides them on how to bring up concerns, and go through child development and early interaction with the parents.

Availability of the intervention in Finland

The Early Interaction promotion project –method training is targeted for education, social and health care professionals, who are working with baby and child families. The training lasts for two years and is based on specific material. In Finland, the training is provided by the Universities of applied sciences and by the Early Interaction promotion project –trainers.

The Early Interaction promotion project has been developed as a part of the European Early Promotion (EEPP) – research project. In the Finland, the Social and Health Ministry and the Finnish Institute for Health and Welfare have been responsible for the development and research of the Early Interaction Promotion. In Finland, the education, and social and health care professionals have applied the intervention, especially in the child health clinics.

Research- and evidence-based efficacy of the intervention

As a part of EEPP research project, a quasi-experimental non-randomized effectiveness study based on group comparison design has been conducted at the University of Tampere. The evaluation of the working methods, which were developed during the research project, stated that the children, who participated in the intervention, had a better physical health compared to the control group. In the intervention group, mothers had less symptoms of mild depression that the mothers in the control group, and the observed mother-child interaction was better than in the group who participated in the child health clinic follow-up. The study had small effect sizes. (Davis ym. 2005). In the two years follow-up no difference was found between the groups regarding child-parent interaction (Puura ym. 2005). There is moderate research-based evidence for the effectiveness of the intervention.

Literature

Davis, H., Dusoir, T., Papadopoulou, K., Dimitrakaki, C., Cox, A., Ispanovic-Radojkovic, V., Puura K., Vizacou, S., Paradisiotou, A., Rudic, N., Chisgolm, B., Leontiou, F., Mäntymaa, M., Radosavljev, J., Riga, E., Day, C. & Tamminen, T. (2005). Child and family outcomes of the European early promotion project. International Journal of Mental Health Promotion, 7, 63–81.

Puura, K., Davis, H., Mäntymaa, M., Tamminen, T., Roberts, R., Dragonas, T., Papadopoulu, K., Dimitrakaki, C., Paradisiotou, A., Vizacou, S., Leontiou, F., Rudic, N., Miladinovic, T. & Radojkovic, A. (2005). The outcome of the European early promotion project: Mother-child interaction. International Journal of Mental Health Promotion, 7, 82–94.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The intervention aims to enhance the mother’s mentalization ability and to teach her cognitive-behavioral methods to control depression and anxiety. The intervention provides support for the mother’s emotional ability to respond to her baby’s needs and for the formation of the attachment relationship.

Description of the intervention

The Nurture and Play is a group-based intervention for pregnant women and families with a baby, where the mother suffers from depression, anxiety or discordant attitude towards parenthood. The intervention lies on the theories of mentalization and attachment relationship as well as research-evidence on the adverse effects of antenatal depression on child development (Calkins & Hill 2007; Field 2011, Gentile 2017). The intervention is designed to be delivered during pregnancy and the first year of the child. The peer groups gather four times during pregnancy and seven times after childbirth. The family is visited once after the childbirth. Two professionals who have received a Nurture and Play –training steer the peer groups. Each meeting is structured by a defined theme but the mothers are provided an opportunity to discuss among themselves too. A Nurture and Play guidebook is available for use.

Availability of the intervention in Finland

The Nurture and Play is aimed at social and health care professionals. Training is provided in Lahti by the Deaconess Institute and Pilke clinic in Helsinki. The intervention has been developed in the Lahti Deaconess Institute’s Magic of Babies –project. The intervention can be used in social and health care, especially in the maternity and child health clinics. The Nurture and Play group-based intervention has been delivered mainly in the capital region and in Päijät-Häme.

Research- and evidence-based efficacy of the intervention

There is a Finnish RCT study on the Nurture and Play intervention (Salo et al. 2019). In the study, the reflexive ability and emotional presence increased more in mothers who participated (n = 24) in the Nurture and Play group-based intervention compared to the mothers in the control group (n = 21).  The intervention has moderate research-based evidence of effectiveness in Finland.

Literature

Calkins, S. D. & Hill, A. (2007). Caregiver influences on emerging emotion regulation. In book Gross JJ. (ed.): Handbook of emotion regulation. The Guilford Press: New York, 229–248.

Field, T. (2011). Prenatal depression effects on early development: a review. Infant Behavior and Development, 34, 1–14.

Gentile, S. (2017). Untreated depression during pregnancy: short-and long-term effects in offspring. A systematic review. Neuroscience, 342, 154–166.

Salo, S. J., Flykt, M., Mäkelä, J., Biringen, Z., Kalland, M., Pajulo, M. & Punamäki, R. L. (2019). The effectivess of Nurture and Play: a mentalisation-based parenting group intervention prenetally depressed mothers. Primary health Care Research & Development, 20, 1–11.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The aim of the intervention is to strengthen positive parenting methods with their children who display behavioural problems, thereby strengthening the child’s self-esteem and coping in everyday situations.

Description of the intervention

The incredible years is a group-based intervention for parents of 3–12 years old children, who display behavioural problems or have a behavioural disorder. The intervention lies on the theories of social learning, attachment relationship and cognitive-behaviour as well as on research-based knowledge on prevention and treatment of behavioral problems. Peer groups are led by two professionals working with child families, who have received Incredible Years group leader –training. The topics are dealt with according to structured methods in the parent groups. The peer groups father weekly 12–20 times, and the aim of the groups is for parents to learn new methods of parenting. The emphasis on shared activity for the child and parents, setting boarders, controlling the child’s behavior and the parents’ empathy towards the child. The parents are supported, eg. in weekly phone calls, in their adopting the new parenting skills.

Availability of the intervention in Finland

Professionals working with child families can receive a parent group leader –training. The Research Center for Child Psychiatry at the University of Turku organizes the training, and background for the material and contents of the training lies partly on international co-operation. The intervention is a part of a series of interlocking, evidence-based Incredible Years methods that have been developed in the USA. In Finland, the intervention is used in the child family services.

Research- and evidence-based efficacy of the intervention

There is an international meta-analysis of the intervention (Menting et al. 2013), RCT-studies (e.g. Scott et al. 2014) and reviews. There are also a Nordic RCT-study on the interventions (Axberg & Broberg 2012; Larsson et al. 2009; Stattin et al. 2015). The intervention has been shown to effectively reduce the child’s aggressiveness (Larsson et al. 2009), behavioural problems (Axberg & Broberg 2012; Karjalainen et al. 2016) and parents’ perceived stress (Larsson et al. 2009; Stattin et al. 2015) compared to the control group. In addition, the intervention has been found to increase the parents’ perceived competence (Stattin et al. 2015). There is abundant research-based evidence of effectiveness of the intervention.

Literature

Axberg, U. & Broberg, A. (2012). Evaluation of ‘‘The incredible years’’ in Sweden: The transferability of an American parent-training program to Sweden. Scandinavian Journal of Psychology, 53, 224–232.

Karjalainen, P., Santalahti, P. & Sihvo, S. (2016). Vaikuttavatko vanhemmuustaitoja tukevat ohjelmat lapsen käytöshäiriöiden ja -ongelmien ehkäisyssä ja vähentämisessä? Duodecim, 10, 967–974.

Larsson, B., Fossum, S., Clifford, G., Drugli, M. B., Handegård, B. H. & Morch, W-T. (2009). Treatment of oppositional defiant and conduct problems in young Norwegian children: Results of randomized controlled trial. European Child and Adolescent Psychiatry, 18, 42–52.

Menting, A. T., de Castro, B. O. & Matthys, W. (2013). Effectiveness of the Incredible years parent training to modify disruptive and prosocial child behavior: A meta-analytic review. Clinical Psychology Review, 33, 901–913.

Scott, S., Briskman, J. & O’Connor, T. G. (2014). Early prevention of antisocial personality: long-term follow-up of two randomized controlled trials comparing indicated and selectiveapproaches. American Journal of Psychiatry, 171, 649–657.

Stattin, H., Enebrink, P., Özdemir, M. & Gianotta, F. (2015). A national evaluation of parenting programs in Sweden: The short-term effects using an RCT effectiveness design. Journal of Consulting and Clinical Psychology, 83(6), 1069–1084.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The aim of the KiVa anti-bullying program is to prevent bullying in the primary school, increase empathy among pupils and provide secure methods to intervene on bullying situations. The occurrence of bullying can be followed in schools, which participate in the program.

Description of the intervention

KiVa antibullying is an operational program, which is targeted at school children at grades from first to ninth, and it comprises preventive measures of bullying for all pupils, resolving of all bullying cases and follow up. KiVa antibullying program is based on human right and legal obligations to prevent bullying, research-based knowledge of bullying as a group phenomenon (Salmivalli et al. 1996) and negative impacts of bullying on the bully (Klomek et al. 2015; Ttofi et al. 2012) and the target of the bullying (Gini & Pozzoli 2013; Hawker & Boulton 2000; Ttofi et al. 2011). KiVa antibullying contains thematic and targeted classroom lessons for all pupils and targeted measures for the bullying situations. The program measures include also a KiVa team consisting of teachers who resolve bullying cases, KiVa-material delivered to families and KiVa logos presented at schools. Follow up of the bullying prevention and realization of the measures is conducted via annual questionnaires. Digital KiVa appliations have been developed to supplement the guidebook and material for teachers.

Availability of the intervention in Finland

No training is required for adopting the KiVa antibullying program because its application is based on the guidebook for teachers, teaching and training materials and various KiVa applications. KiVa antibullying program has been developed in Finland at the University of Turku in cooperation of stakeholders, parents, children and professionals of various fields. Approximately a half of the Finnish primary schools used the KiVa antibullying program in 2019. The program is available in Finland for all educational institutions, which provide primary education.

Research- and evidence-based efficacy of the intervention

The KiVa antibullying program has been investigated in international studies and Finnish RCT- and quasi-experimental study designs. In the Finnish RCT-study conducted in 275 schools, bullying was reduced among pupils of 4th to 6th grades in the intervention group   (n = 4 201), which participated in KiVa, compared to the control group (n = 3 965) (Kärnä et al. 2011a). In a 9-month follow up of a Finnish quasi-experimental study, bullying was reduced among pupils from the first to ninth grades in primary schools using the KiVa antibullying program as compared to schools not using it (Kärnä et al. 2011b). Bullying or becoming a target of bullying was 1,2 times greater in comparison schools (not using the program). The impact of the intervention increased in the first four grades but in other grades the effectiveness was reduced and there was no statistical significance between the intervention and comparison groups in the secondary schools. There is research-based evidence of effectiveness of KiVa antibullying program in reducing bullying and the program has been evaluated as a strong intervention.

Literature

Gini, G. & Pozzoli, T. (2013). Bullied children and psychosomatic 618 problems: A meta-analysis. Pediatrics 132, 720–729.

Hawker, D. S. J. & Boulton, M. J. (2000). Twenty years’ research on peer victimization and psychosocial maladjustment: a meta-analytic review of cross-sectional studies. Journal of Child Psychology and Psychiatry, 41(4), 441–455.

Klomek, A. B., Sourander, A. & Elonheimo, H. (2015). Bullying by peers in childhood and effects on psychopathology, suicidality, and criminality in adulthood. Lancet Psychiatry, 2(10), 930–941.

Kärnä, A., Voeten, M., Little, T. D., Poskiparta, E., Kaljonen, A. & Salmivalli, C. (2011a). A large-scale evaluation of the KiVa antibullying program: grades 4-6. Child Development, 82(1), 311–330.

Kärnä, A., Voeten, M., Little, T. D., Poskiparta, E., Alanen, E. & Salmivalli, C. (2011b). Going to scale: A nonrandomized nationwide trial of the KiVa antibullying program for grades 1–9. Journal of Consulting and Clinical Psychology, 79(6), 796–805.

Salmivalli, C., Lagerspetz, K. M. J., Björkqvist, K., Österman, K. & Kaukiainen, A. (1996). Bullying as a group process: Participant roles and their relations to social status within the group. Aggressive Behavior, 22, 1–15.

Ttofi, M. M., Farrington, D. P., Lösel, F. & Loeber, R. (2011). Do the victims of school bullies tend to become depressed later in life? A systematic review and meta‐analysis of longitudinal studies. Journal of Aggression, Conflict and Peace Research, 3(2), 63–73.

Ttofi, M. M., Farrington, D. P. & Lösel, F. (2012). School bullying as a predictor of violence later in life: A systematic review and meta-analysis of prospective longitudinal studies. Aggression and Violent Behavior, 17(5), 405–418.

Abstract

Delivery of the intervention

Group-based

Aim of the intervention

The aim of the intervention is to teach children methods to reduce stress-reaction. The TRT-intervention is suitable for treating symptoms of post-traumatic stress disorder (PTSD), coping after a trauma and support the child’s recovery.

Description of the intervention

TRT is a group-based intervention for over 8 year-old children and their parents, who have been exposed to armed conflicts or natural catastrophes. The theoretical framework is provided by the trauma-focused cognitive-behavioural therapy. The intervention comprises five sessions in consecutive weeks for children and two consecutive weeks for the parents at the beginning of the children’ group. The parent groups focus on supporting and guiding methods, with which the parents can help their children in the traumatic situation. After the TRT-intervention a follow-up session can be organized to reinforce the learned contents and to share peer experiences. Intervention uses a guidebook developed for the intervention.

Availability of the intervention in Finland

Mental health, social and healthcare and education professionals can attain a TRT group leader training, organized by private mental health professionals. They must have been trained as a trainer by the Children and War Foundation (CWF). The trainings have been organized in Finland primarily based on bookings. The TRT has been originally developed for treating traumatic experiences caused by natural catastrophes and conflicts. The intervention has been used in Finland as a group-based method for immigrant children at school, in crisis work and for victims of sexual abuse.

Research- and evidence-based efficacy of the intervention

The effectiveness of the TRT-intervention has been tested in international RCT-studies, which have focused on the post-traumatic stress disorder (Barron et al. 2013; 2016; Pityaratstian et al. 2015; Qouta et al. 2012) in response to natural catastrophes (Pityaratstian et al. 2015) and conflicts (Barron et al. 2013; 2016; Diab et al. 2015; Qouta et al. 2012), depressive symptoms (Barron et al. 2013; 2016; Qouta et al. 2012), traumatic sadness and academic accomplishments (Barron et al. 2013), resilience (Diab et al. 2015) and dissociation (Barron  et al. 2016) in children. The studies have found strong evidence for the intervention in reducing depressive symptoms and traumatic sadness. Post-traumatic stress disorder symptoms were found to decrease in the intervention group compared to the control group, but the effect on the academic accomplishment, resilience and dissociation was small. There is neither peer reviewed research nor research-based evidence of effectiveness of the intervention in Finland.

Literature

Barron, I., Abdallah, G., & Heltne, U. (2016). Randomized control trial of Teaching Recovery Techniques in rural occupied Palestine: Effect on Adolescent Dissociation. Journal of Aggression, Maltreatment & Trauma, 25(9), 955–973.

Barron, I., Abdallah, G., & Smith, P. (2013). Randomized control trial of a CBT trauma recovery program in Palestinian school. Journal of Loss and Trauma: International Perspectives on Stress & Coping, 18(4), 306–321.

Diab, M., Peltonen, K., Qouta, S. R., Palosaari, E., Punamäki, R-L. (2015). Effectiveness of psychosocial intervention resilience among war-affected children and the moderating role of family factors. Child Abuse & Neglect, 40, 24–35.

Pityaratstian, N., Piyasil, V., Ketumarn, P., Sitdhiraksa, N., Ularntinon, S., & Pariwatcharakul, P. (2015). Randomized controlled trial of group cognitive behavioural therapy for post-traumatic stress disorder in children and adolescents exposed to tsunami in Thailand. Behavioural and Cognitive Psychotherapy, 43, 549–561.

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