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Abstract
The outcomes of school-based counseling incorporating the Partners for Change Outcome Monitoring System (PCOMS) were evaluated using a cohort design, with multilevel modeling to identify predictors of change. Participants were 288 7–11 year olds experiencing social, emotional or behavioral difficulties. The intervention was associated with significant reductions in psychological distress, with a pre-post effect size (d) of 1.49 on the primary outcome measure and 88.7% clinical improvement. Greater improvements were found for disabled children, older children, and where CBT methods were used. The findings provide support for the use of systematic feedback in therapy with children.
Se evaluaron los resultados del counseling escolar acompañado por el sistema de feedback denominado Sistema de Monitoreo de Resultados a través del Acompañamiento en el Proceso de Cambio (PCOMS) usando un diseño de cohorte con una modelización multi-nivelada para detectar predictores de cambio. Los participantes fueron 288 escolares de entre 7 y 11 años de edad que experimentaban dificultades emocionales, sociales o comportamentales. La intervención se asoció con significativas reducciones en los niveles de sufrimiento subjetivo con un tamaño del efecto (effect size) (d) de 1.49 en la medida primaria de resultados y 88.7% de mejoría clínica. Los resultados fueron aun mayores en niños discapacitados, de mayor edad dentro del rango y cuando se usaron métodos de terapia cognitivo conductual. Los resultados ofrecen evidencia empírica que sustenta la utilización sistemática de feedback en las psicoterapias con niños
Die Ergebnisse einer schulbasierten Beratung, welche das Partners for Change Outcome Monitoring System (PCOMS) beinhaltet, wurden anhand eines Kohortendesigns mit Hierarchisch Linearen Modellen evaluiert, um Prädiktoren für Veränderungen zu identifizieren. Studienteilnehmer waren 288 7-11jährige Schüler, welche soziale, emotionale oder behaviorale Schwierigkeiten aufwiesen. Die Intervention führte zu signifikanten Reduktionen in der psychologischen Belastung, mit einer Prä- Posteffektstärke von (d) = 1.49 auf den primären Ergebnismaßen und zu 88.7% klinischer Verbesserung. Größere Verbesserungen wurden für körperlich behinderte und ältere Kinder, sowie für diejenigen, bei denen KVT Methoden angewandt wurden, gefunden. Diese Ergebnisse sprechen dafür, systematisches Feedback in der Therapie von Kindern und Jugendlichen anzuwenden.
E’ stato valutato l'esito di uno school-based counseling che includeva il Partners for Change Outcome Monitoring System (PCOMS) in un disegno di ricerca di coorte, secondo un modello multi-livello per identificare i predittori di cambiamento. I partecipanti erano 288 di età compresa tra i 7 e gli 11 anni; tutti avevano vissuto difficoltà sociali, emozionali o comportamentali. E’ stato osservato che l'intervento era associato ad una significativa riduzione del distress psicologico, con un effect size pre- e post di 1.49 rispetto alla misura di esito primaria, ed un miglioramento clinico del 88.7%. I miglioramenti maggiori sono stati riscontrati per i bambini disabili, i bambini più grandi di età, e dove era stato utilizzato il metodo CBT. Queste scoperte incoraggiano l'uso del feedback sistematico nella terapia con i bambini.
Acknowledgements
Thanks to Monica McCann, Barnardo's Northern Ireland; Barry Duncan, Heart and Soul of Change Project; Robert J. Reese and Michael D. Toland, University of Kentucky; Bill Stiles, Glendale Springs, North Carolina; and to Andy Fugard and Harriet Hockaday at the CAMHS Outcome Research Consortium (CORC), a grass-roots not-for-profit learning collaboration, started in 2002 as a joint initiative between a group of front-line clinicians, managers and administrative leads interested in developing best practice in relation to outcome evaluation to inform service development (see http://www.corc.uk.net/).