Parent–child inpatient treatment for children with behavioural and emotional disorders: a multilevel analysis of within-subjects effects

Elena Ise,Dieter Breuer,Sabine Schröder,Manfred Döpfner

doi:10.1186/s12888-015-0675-7

Elena Ise, Dieter Breuer + Show 2 more

Open Access

https://doi.org/10.1186/s12888-015-0675-7

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Abstract

BackgroundThe importance of parental involvement in child treatment is well-established. Several child psychiatric clinics have, therefore, set up inpatient family units where children and parents are both actively involved in the treatment. Unfortunately, evidence supporting the benefits of these units is sparse.MethodsWe evaluated the effectiveness of inpatient treatment for families with severe parent–child interaction problems in a child psychiatric setting. Consecutive admissions to the parent–child ward (N = 66) were studied. A within-subjects design was used with four assessment points (baseline, admission, discharge, four-week follow-up). Outcome measures were 1) parent and teacher ratings of child behaviour, and 2) parent self-ratings of parenting practices, parental strains and parental mental health. Data were analyzed using multilevel modelling for longitudinal data (piecewise growth curve models).ResultsAll parent-rated measures improved significantly during the four-week treatment period (d = 0.4 – 1.3). These improvements were significantly greater than those observed during the four-week pre-admission period. In addition, benefits were maintained during the four-week follow-up period. Only parents’ self-efficacy in managing their child’s behaviour showed continued improvement during follow-up. Teacher ratings of children’s disruptive behaviour at school were stable during the pre-admission period and showed significant improvements at follow-up (d = 0.3 – 0.4).ConclusionsWe conclude that parent–child inpatient treatment has positive effects on child and parent behaviour and mental health, and can therefore be recommended for children with behavioural and emotional disorders and severe parent–child interaction problems.

Highlights

IntroductionSeveral child psychiatric clinics have, set up inpatient family units where children and parents are both actively involved in the treatment
The importance of parental involvement in child treatment is well-established
The effectiveness of parental involvement in child psychiatric outpatient treatment has been demonstrated in several clinical trials with different patient populations, including children with Attention Deficit-/Hyperactivity Disorder (ADHD; [10]), Oppositional Defiant and Conduct Disorders (ODD/conduct disorder (CD); [11, 12]), Autism Spectrum Disorders (ASD; [13]) and emotional disorders like anxiety and depression [14]

Summary

Introduction

Several child psychiatric clinics have, set up inpatient family units where children and parents are both actively involved in the treatment. Inpatient treatment is an important component of child and adolescent mental health services. It is considered the most restrictive type of care [1] and admission should be reserved for children with severe psychiatric symptomatology. The effectiveness of parental involvement in child psychiatric outpatient treatment has been demonstrated in several clinical trials with different patient populations, including children with Attention Deficit-/Hyperactivity Disorder (ADHD; [10]), Oppositional Defiant and Conduct Disorders (ODD/CD; [11, 12]), Autism Spectrum Disorders (ASD; [13]) and emotional disorders like anxiety and depression [14]. For young children with disruptive behaviour disorders (ODD/CD, ADHD) parent training programmes that work directly with parents to modify their parenting behaviours are considered as a first line approach [12, 15]

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