Group Cognitive Behavioral Treatment for Parents and Children At-Risk for Physical Abuse: An Initial Study

Abstract

To compare the relative efficacy of two types of group cognitive-behavioral therapy for treating the traumatized child and at-risk or offending parent in cases of child physical abuse (CPA), 24 parents and their children were treated with Combined Parent-Child Cognitive Behavioral Therapy (CPC-CBT) and 20 parents were treated with Parent-Only CBT. Outcome measures assessing children's emotional and behavioral functioning and parents' parenting skills were administered to both parent and child participants before treatment, after 15 sessions of treatment, and 3 months after the completion of treatment. A series of correlated t tests and analyses of covariance were used to compare the scores on the outcome measures. The children and parents in the CPC-CBT group demonstrated greater improvements in total posttraumatic symptoms and positive parenting skills, respectively, compared to those who participated in the Parent-Only CBT group. The parents in the Parent-Only CBT group reported using less corporal punishment to manage their children's behavior at posttest than the parents in the CPC-CBT group. The differential benefits of including the child in treatment are discussed.

KEYWORDS:

• child physical abuse
• cognitive behavior therapy

The project described was supported by Grant Number 5R21MH65951 from the National Institute of Mental Health (NIMH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIMH. The authors thank the study therapists, Donyale Baker, MSW, Leah Behl, PhD, Eloise J. Berry, PhD, Alissa Glickman, PhD, project coordinator Beth Cooper, MS, Institute staff, students, and post-doctoral appointees and the families who participated in this study. A special thanks to Ms. Noelle Davis who assisted with the preparation of the manuscript.

Notes

*p < .05, **p < .01.

Note. Those components included only in the Combined Parent-Child group are in bold.

*Parent training includes praise, positive reinforcement, use of positive and negative consequences, contingency management, behavioral contracts and charts, work chores, development of house rules, time-out, as well as communication and negotiation skills and active listening.

Note. APQ-C = Alabama Parenting Questionnaire-Child Version, APQ-P = Alabama Parenting Questionnaire-Parent Version, CBCL = Child Behavior Checklist, K-SADS-PL = Schedule for Affective Disorders and Schizophrenia for School Age Children.

*p < .05, **p < .01, ***p < .001.

Note. APQ-C = Alabama Parenting Questionnaire-Child Version, APQ-P = Alabama Parenting Questionnaire-Parent Version, CBCL = Child Behavior Checklist, K-SADS-PL = Schedule for Affective Disorders and Schizophrenia for School Age Children. Multivariate Analysis of Covariance F(7, 45) of Type of Treatment for set of seven outcome measures = 5.12***, Wilks' λ = .56.

*p < .05, ***p < .001.