Novel approaches to evaluating the effectiveness of intervention elements for improving the psychosocial functioning of children and adolescents.
Chair(s): Loes van Rijn - van Gelderen (University of Amsterdam, Netherlands, The)
Discussant(s): Loes van Rijn - van Gelderen (University of Amsterdam)
One in seven young people experiences psychological health problems, with untreated conditions leading to academic struggles and broader health consequences. Therefore, effective interventions for children, adolescents, and parents are essential, yet research shows that not everyone benefits from current approaches.
This symposium brings together diverse scientific approaches, including multiple-case studies and intensive longitudinal research, integrating both quantitative and qualitative designs. It examines populations ranging from pre-school children to adolescents across various European countries and explores interventions from parenting programs to element-based strategies for adolescents, all aimed at evaluating the effectiveness of common intervention elements.
First, Brechtje de Mooij will share whether the focus of feedback in a parenting intervention is related to the effectiveness of the intervention. She presents data from a multiple-case study of 45 families (children aged 2-12 years), which utilized pre-post, and follow-up questionnaires and twice-daily questionnaires in the days before and after each session.
Second, Truls Tømmerås will present data from the iterative optimization of a novel personalized transdiagnostic parenting intervention designed to prevent and treat internalizing and externalizing mental health issues. Findings from two test cycles evaluating two different versions of the intervention will be presented, including multiple-baseline designs to assess individual change across baseline and intervention phases, as well as user-feedback identifying areas for optimization.
Third, John Kjøbli will presents findings from a 90-day intensive longitudinal study examining the effects of key intervention elements (Positive Activities, Exposure, Cognitive Restructuring, and Mindfulness). He will discuss how these insights, alongside qualitative interviews, guide further intervention refinement.
Finally, Loes van Rijn – van Gelderen will serve as the discussant, integrating insights from these studies and providing a reflection on their implications for research and practice.
Together, these studies provide valuable insights into optimizing mental health interventions, ensuring resources are directed toward strategies proven to be effective.
Presentations of the Symposium
Does feedback in parenting interventions improve parenting? A Multiple Case Study investigating the effects of the Family Check-Up
Brechtje de Mooij, Laura Wielemaker, Geertjan Overbeek, Loes van Rijn - van Gelderen
University of Amsterdam
The Family Check-Up (FCU) is a short intervention to support children's psychosocial functioning by optimizing parenting behavior in 3 standardized sessions. Session 1 consists of an interview to work on rapport, motivation for change, and getting to know the family. Session 2 consists of a self-report questionnaire and observations of family interaction tasks to obtain information about parenting- and child behavior and interactions, and family management. In session 3, the FCU therapist combines this information to provide (video)feedback to parents on which aspects of parenting and family management are strengths or areas for improvement. Various RCTs have shown that the FCU is effective: parenting skills improve and children's psychosocial functioning increases in families who completed the FCU (e.g., Smith et al., 2014;). However, the FCU has only been tested as a whole, which makes it unclear when and how parents change their behavior during the intervention. Additionally, it remains unclear to what extent the focus of the feedback in the Family Check-Up influences its’ effects.
We fill this knowledge gap by conducting a multiple-case study with 45 families in which we intensively assess parenting and children's psychosocial functioning. Parents complete short questionnaire twice-daily for five to seven days before each session (baselines) and five days after each session (intervention phases). We will test whether parenting and/or child psychological functioning changes differ between baseline and intervention phases using mixed models regression analyses. If the change in an intervention phase is significantly larger than in the baseline phase, this shows intervention effectiveness. In addition, using repeated measures MANCOVA’s (3 waves: pre, post, follow-up), we will test whether the change in parenting (parent-child relationship quality, positive behavioral support, and effective limit setting) is dependent on the (video)feedback provided. Data collection is ongoing; preliminary results will be available in August.
Optimizing a Novel Transdiagnostic Parent Training Intervention to Prevent Childhood Mental Health Problems
Truls Tømmerås, Agathe Backer-Grøndahl, Andreas Høstmælingen
Norwegian Center for Child Behavioral Development
To prevent and treat internalizing problems (e.g., anxiety, depression) and externalizing problems (e.g., conduct issues, oppositional behavior) in children aged between 4 and 12, a personalized transdiagnostic intervention—Supportive Parents – Coping Kids (SPARCK) – has been co-created with stakeholders in Norwegian municipal frontline services. SPARCK builds on Generation PMTO and the social interaction learning model, integrating active practice elements from other effective change models, including cognitive behavioral therapy, family accommodation, emotion socialization, and attachment-based interventions. Over the course of up to 12 sessions, parents receive tailored elements designed to address child symptoms, family strengths and specific challenges.
During the optimization process, an iterative test-refine-retest approach was used to create a usable and effective intervention that aligns with routine practice contexts and end-user needs. SPARCK was optimized based on qualitative user-feedback and quantitative individual effect data from single case experimental designs. The mixed-methods design evaluated what works—and what doesn’t—for whom. Two versions of SPARCK were tested with 14 participants in each group. This presentation includes findings from qualitative interviews with caregivers and practitioners, which highlight areas for optimization, as well as data from single case randomized multiple baseline designs assessing internalizing and externalizing individual effects across baseline and intervention phases. Results demonstrate larger effect sizes following the optimization of SPARCK and the introduction of a decision support system, which facilitates improved tailoring of intervention content.
Optimizing an intervention to prevent mental health problems in adolescents using intensive longitudinal data
John Kjøbli1, Emily G. Vira2, Anneli Mellblom3, Thomas Engell3, Line S. Kvamme3, Siri S. Helland3
1Regional Center for Child and Adolescent Mental Health, Oslo, Norway; Institute of Education, University of Oslo, Oslo, Norway, 2Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway; Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway., 3egional Center for Child and Adolescent Mental Health, Oslo, Norway
Kort is an element-based intervention developed to prevent mental health problems in adolescents. The intervention elements are chosen based on systematic reviews and is co-created with adolescents and school health nurses. Optimizing interventions is crucial before experimental testing, and we have therefore conducted an intensive longitudinal study to optimize the intervention elements: Positive activities, Exposure, Cognitive restructuring, and Mindfulness.
To capture day-to-day variations in emotion regulation, 50 adolescents were invited to complete daily reports of the following emotion regulation strategies: rumination, distraction, reactive impulsivity, cognitive reappraisal, acceptance, and savoring. Intensive longitudinal data were collected over a baseline period of two weeks and continued for 90 days during the intervention. Due to large variations in the timing of receiving intervention elements across adolescents, analyses were performed within a single-case design. Between-case standardized mean differences were estimated, where individual trends before and after receiving an element were compared and the individual effects were summarized.
Preliminary results from between-case standardized mean difference analyses showed positive effects of the element cognitive restructuring on cognitive reappraisal, as predicted. Results also showed a positive effect of the element exposure on distraction.
Intensive longitudinal data enables us to estimate the immediate changes during an intervention related to specific intervention elements. The results will be triangulated with qualitative interviews with adolescents and clinicians to inform further optimization.
