Multiple Family Groups for Children with Disruptive Behavior Disorders: Child Outcomes at 6-Month Follow-Up.

This paper reports on the 6-month follow-up outcomes of an effectiveness study testing a multiple family group (MFG) intervention for clinic-referred youth (aged 7-11) with disruptive behavior disorders (DBDs) and their families in socioeconomically disadvantaged families compared to services-as-usual (SAU) using a block comparison design. The settings were urban community-based outpatient mental health agencies. Clinic-based providers and family partner advocates facilitated the MFG intervention. Parent-report measures targeting child behavior, social skills, and impairment across functional domains (i.e., relationships with peers, parents, siblings, and academic progress) were assessed across four timepoints (baseline, mid-test, post-test, and 6-month follow-up) using mixed effects regression modeling. Compared to SAU participants, MFG participants reported significant improvement at 6-month follow-up in child behavior, impact of behavior on relationship with peers, and overall impairment/need for services. Findings indicate that MFG may provide longer-term benefits for youth with DBDs and their families in community-based settings. Implications within the context of a transforming healthcare system are discussed.

A learning collaborative supporting the implementation of an evidence-informed program, the "4Rs and 2Ss for children with conduct difficulties and their families".

In this qualitative study the authors examine factors associated with the successful implementation and plans for continued use of an evidence-informed intervention, the 4Rs and 2Ss Program for Strengthening Families, in a sample of 29 New York State, Office of Mental Health licensed child mental health clinics. A learning collaborative (LC) approach was used as a vehicle for supporting training and implementation of the program. The PRISM theoretical framework ( Feldstein & Glasgow, 2008 ) was used to guide the data analysis. Data were analyzed using a multi-phase iterative process, identifying influences on implementation at multiple levels: the program (intervention), the external environment, implementation and sustainability infrastructure, and recipient characteristics. Clinics that were more proactive evidenced staff with advanced organizational skills were able to take advantage of the trainings and supports offered by the LC and fared better in their ability to adopt the intervention. The ability to adapt the intervention to the specific constraints of the clinics was a strong influence on continued use following the end of the LC. These preliminary results suggest that the supports provided by the LC are useful in consolidating information about the process of implementing evidence-informed interventions in community mental health settings. The impact of these supports is also based on their interactions with specific clinic contextual factors.

Physical and mental health functioning of urban HIV-infected and uninfected mothers with problem drinking.

Problem drinking is of great concern for mothers, especially those who are HIV-infected. We compared background characteristics, co-occurring drug use, and physical and mental health functioning of urban HIV-infected and uninfected mothers with problem drinking who were raising adolescents. Mothers in both groups reported similarly high levels of lifetime and current alcohol and drug use and poor physical and mental health. Health outcomes for mothers with problem drinking do not appear to be exacerbated by HIV status. Implications for intervention efforts with mothers and their adolescent children are discussed.