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Supporting foster families with a high risk on unplanned termination. A Randomized Controlled Trial study (RCT) of Parent Management Training Oregon (PMTO)


- candidate number15782
- NTR NumberNTR4282
- ISRCTNISRCTN wordt niet meer aangevraagd.
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR28-nov-2013
- Secondary IDsZonMw 80-82435-98-10114
- Public TitleSupporting foster families with a high risk on unplanned termination. A Randomized Controlled Trial study (RCT) of Parent Management Training Oregon (PMTO)
- Scientific TitleSupporting foster families with a high risk on unplanned termination. A Randomized Controlled Trial study (RCT) of Parent Management Training Oregon (PMTO)
- ACRONYM
- hypothesis(1) PMTO, compared to Care As Usual (CAU), will result in significant benefits in terms of: (a) parenting skills both at the end of the PMTO treatment, (b) child behavior problems, (c) parenting stress, (d) parental well-being, both at the end of the PMTO treatment (T1) as well as 4 months later (T2).
(2) PMTO, compared to Care As Usual (CAU), will result in less placement disruption one year after PMTO ends (T3)
(3) PMTO effectiveness will be significant and positive related to the working alliance between foster-parents and the PMTO trainer, motivation to participate.
- Healt Condition(s) or Problem(s) studiedBehavioral problems, Parenting problems
- Inclusion criteriaFoster parents of long term foster children aged 4-12 with heightened problem behavior (SDQ >= 14 and PDR> 5), willingness to be randomly assigned
- Exclusion criteriafoster parents already received PMTO training, crisis or short term placements
- mec approval receivedyes
- multicenter trialyes
- randomisedyes
- masking/blindingNone
- controlActive
- groupParallel
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-dec-2010
- planned closingdate1-aug-2015
- Target number of participants75
- InterventionsThe intervention group receives the Parent Management Training Oregon (PMTO). PMTO is an ambulant intervention program aimed at the parents of children (4-12 years old) with behavior problems. PMTO is based on the Social Interaction Learning theory (SIL; Patterson, 2005), which emphasizes the importance of the social context in the development of children. The model specifies that parents mediate the effect of contextual factors, such as stress, poverty, parental psychology, on child adjustment. Therefore, parents are the primary recipients of PMTO intervention. PMTO focusses on enhancing 5 theoretically based effective parenting strategies: skill encouragement, setting limits, monitoring, problem solving, and positive involvement. Parents follow a weekly session with a trainer without their children being present. The central role of the PMTO trainer is to teach these effective strategies and to coach parents in applying them to diminish coercive processes through these core practices. Furthermore, PMTO also pays attention to supportive strategies: giving clear instructions, emotion-regulation; observing and recording behavior; communication. While all parents start with learning to use and practice clear instructions, skill encouragement and setting limits, the other strategies do not have a standardized moment in the program. The moment is tailored to the specific goals and processes of the specific family. The number of sessions varies, mostly between 15-25. The Control group receives Care as Usual (CAU), which can be anything but PMTO. CAU might therefore range from no additional help (besides the regular supervision/counseling by foster care organizations), to any other help or mixture of help related to the foster child�s problem, and is representative of current clinical practice. CAU will be described in terms of type of used care and frequency.
- Primary outcomeParenting skills
- Secondary outcomeChild behavior, parenting stress, well-being parents, placement disruption
- TimepointsScreening1, screening2, T0 after randomization and before starting PMTO in intervention group, T1 after ending PMTO, T2 4 months after ending PMTO, T3 year after ending PMTO The following instruments are used at the following timepoints: Screening 1: SDQ, background variables foster child and foster family Screening 2: PDR To all groups on T0, T1, T2: problem behavior (CBCL, TRF), Wellbeing foster child and foster parents(Cantrill), Parentingstress (PSI/NOSI-R), Parenting behavior/skills (PBQ). To both groups on T1: used care To both groups T3: placement disruption, reasons for disruption, wellbeing child (Cantril) To PMTO group on T0: Motivation to participate in PMTO (Parent motivation invenroty) To PMTO group on T1: Working alliance (WAI-s), Satisfaction (C-toets), experienced changes (Beste). The following instruments are used at the following time points: Screening 1: SDQ, background variables foster child and foster family Screening 2: PDR To all groups on T0, T1, T2: problem behavior (CBCL, TRF), Wellbeing foster child and foster parents(Cantril), Parentingstress (PSI/NOSI-R), Parenting behavior/skills (PBQ). To both groups on T1: used care To both groups T3: placement disruption, reasons for disruption, wellbeing child (Cantril) To PMTO group on T0: Motivation to participate in PMTO (Parent motivation invenroty) To PMTO group on T1: Working alliance (WAI-s), Satisfaction (C-toets), experienced changes (Beste).
- Trial web sitewww.pmto.uva.nl
- statusopen: patient inclusion
- CONTACT FOR PUBLIC QUERIES Anne Maaskant
- CONTACT for SCIENTIFIC QUERIES Anne Maaskant
- Sponsor/Initiator University of Amsterdam (UvA)
- Funding
(Source(s) of Monetary or Material Support)
ZON-MW, The Netherlands Organization for Health Research and Development, University of Amsterdam
- Publications--
- Brief summaryAround 21.000 children live in foster care in the Netherlands, of whom about half for a period of more than a year. International research shows that between 20 and 50% of long term placements end unplanned, mainly due to behavioral problems of the foster child and the related parenting stress among the foster parents. These disrupted placements increase the risk of consecutive instable placements and may in turn cause more emotional and behavioral problems and negative developmental outcomes of the child. Extensive and personal support of foster parents in dealing with the behavior of their foster child, might help foster parents to handle the problem behaviour better. Additionally, this might reduce the risk on placement disruption. The Parent Management Training Oregon model (PMTO) might be a useful intervention in this context. In the current research project the effectiveness of PMTO against care as usual (cau) is tested for foster care. The following specific hypothesis will be tested: (1) PMTO, compared to Care As Usual (CAU), will result in significant benefits in terms of: (a) parenting skills , (b) child behavior problems, (c) parenting stress, (d) parenting wellbeing, both at the end of the PMTO treatment (T1) as well as 4 months later (T2). (2) PMTO, compared to Care As Usual (CAU), will result in less placement disruption one year after PMTO ends (T3). (3) PMTO effectiveness will be significant and positive related to the working alliance between foster-parents and the PMTO trainer and motivation to participate.
Study design: The current study involves a Randomized Control trial (RCT) with foster parents of children aged 4-12 in long term foster care in three regions in the Netherlands (PMTO vs CAU). Assessments occur at baseline (before intervention group starts treatment; T0), around 6 months (when intervention group ends treatment; T1), and four months later (T2). Additionally placement disruption is measured one year after T2 (T3).
Study population: Foster parents are recruited through three regional foster care organizations. Foster parents of children aged 4-12 in long term foster care with children with heightened levels of behavior problems (as measured in a two-step screening procedure: SDQ total difficulty scores >/=14 and PDR scores > 5) and willing to participate in the RCT are randomly assigned to the intervention and CAU group.
- Main changes (audit trail)
- RECORD28-nov-2013 - 1-okt-2014


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