Collaborative and Proactive Solutions compared with usual care to treat irritability in children and adolescents: a pilot randomized controlled trial

Abstract

ABSTRACT Objective This pilot randomised controlled trial evaluated the acceptability and feasibility of a psychological intervention to manage severe irritability in children and adolescents. Methods Children with severe irritability (9–14 years; 42% male) were randomised to receive six sessions of Collaborative & Proactive Solutions (CPS) or usual clinical care. The primary outcome was acceptability and feasibility of the intervention (participant enrollment, drop-out, intervention session attendance). Key secondary outcomes assessed 4-month post-randomisation included child irritability, quality of life, executive functioning, parent mental health and family functioning. Results Twelve children enrolled in the study (52% uptake). All participants in the CPS group attended ≥2 intervention sessions, and one participant in the usual care group was lost to follow-up. Compared to usual care, the CPS group had improvements in child irritability (Effect Size (ES): −0.4), quality of life (ES: 0.4), executive functioning (ES: −0.4), and family functioning (ES: −0.7). Conclusion It is acceptable and feasible to deliver CPS to severely irritable children and adolescents. Preliminary evidence suggests this non-pharmacological intervention improves important areas of functioning for severely irritable children. Trial registration The trial was prospectively registered on 11 October 2017 with the Australian New Zealand Clinical Trials Registry (www.anzctr.org.au: ACTRN12617001445369).