Intervention Review

Behavioural and cognitive behavioural training interventions for assisting foster carers in the management of difficult behaviour

  1. William Turner1,*,
  2. Geraldine Macdonald2,
  3. Jane A Dennis1

Editorial Group: Cochrane Developmental, Psychosocial and Learning Problems Group

Published Online: 24 JAN 2007

Assessed as up-to-date: 17 SEP 2006

DOI: 10.1002/14651858.CD003760.pub3


How to Cite

Turner W, Macdonald G, Dennis JA. Behavioural and cognitive behavioural training interventions for assisting foster carers in the management of difficult behaviour. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD003760. DOI: 10.1002/14651858.CD003760.pub3.

Author Information

  1. 1

    University of Bristol, School for Policy Studies, Bristol, UK

  2. 2

    School of Sociology, Social Policy and Social Work, Director of Education, Belfast, Northern Ireland, UK

*William Turner, School for Policy Studies, University of Bristol, No. 8 Priory Road, Bristol, BS8 1TZ, UK. w.turner@bristol.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 24 JAN 2007

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

The provision of training for foster carers is now seen as an important factor contributing to the successful outcome of foster care placements. Since the late 1960s, foster carer training programs have proliferated, and few of the many published and unpublished training curricula have been systematically evaluated. The advent of cognitive-behavioural therapy (CBT) and the research evidence demonstrating its effectiveness as a psychotherapeutic treatment of choice for a range of emotional and behavioural problems, has prompted the development of CBT-based training programmes. CBT approaches to foster care training derive from a 'skill-based' training format that also seeks to identify and correct problematic thinking patterns that are associated with dysfunctional behaviour by changing and/or challenging maladaptive thoughts and beliefs.

Objectives

To assess the effectiveness of cognitive-behavioural training interventions in improving a) looked-after children's behavioural/relationship problems, b) foster carers' psychological well-being and functioning, c) foster family functioning, d) foster agency outcomes.

Search methods

We searched databases including: CENTRAL (Cochrane Library Issue 3, 2006), MEDLINE (January 1966 to September 2006), EMBASE (January 1980 to September 2006), CINAHL (January 1982 to September 2006), PsycINFO (January 1872 to September 2006), ASSIA (January 1987 to September 2006), LILACS (up to September 2006), ERIC (January 1965 to September 2006), Sociological Abstracts (January 1963 to September 2006), and the National Research Register 2006 (Issue 3). We contacted experts in the field concerning current research.

Selection criteria

Random or quasi randomised studies comparing behavioural or cognitive-behavioural-based training intervention (in a group or one-to-one settings or both) versus a no-treatment or wait-list control, for foster parents/carers.

Data collection and analysis

Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information.

Main results

Six trials involving 463 foster carers were included. Behavioural and cognitive-behavioural training interventions evaluated to date appear to have very little effect on outcomes relating to looked-after children, assessed in relation to psychological functioning, extent of behavioural problems and interpersonal functioning. Results relating to foster carer(s) outcomes also show no evidence of effectiveness in measures of behavioural management skills, attitudes and psychological functioning. Analysis pertaining to fostering agency outcomes did not show any significant results. However, caution is needed in interpreting these findings as their confidence intervals are wide.

Authors' conclusions

There is currently little evidence about the efficacy of behavioural or cognitive-behavioural training intervention for foster carers. The need for further research in this area is highlighted.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Behavioural and cognitive behavioural training interventions for assisting foster carers in the management of difficult behaviour

Providing training for foster carers is thought to enhance caring attitudes and skills, help foster carers deal more effectively with foster children's behaviour, and decrease foster carer attrition. Although training programs have proliferated, there has been minimal evaluative research to determine whether they are effective.
This review attempted to determine the effectiveness of cognitive-behavioural training interventions. Only six trials involving 463 foster carers were included. Results suggest little evidence of effect on looked-after children, foster carers and fostering agency outcomes.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

行為和認知行為訓練的介入方式,以協助寄養照顧者對於困難行為的處置

對寄養照顧者提供訓練,目前已經被視為成功的寄養安置的一個重要因素。60年代後期以來,寄養照顧者的培訓計劃蓬勃發展,而在很多發表及未發表的培訓課程之中,只有少數經過系統性的評估。認知行為治療(CBT)的進步,且研究證據也顯示其對於廣泛的情緒和行為問題,可作為心理治療介入的選擇,促使CBT的訓練方案的發展。 CBT取向的寄養照顧者訓練,是從「技巧為基礎」的訓練模式衍生,以改變和/或挑戰不良適應的思考和信念的方式,來發現和改正和失能行為相關的有問題的思考模式。

目標

為了評估認知行為訓練介入,在改善 a)被照顧的兒童之行為/關係問題,b)寄養照顧者的心理安適感及功能,c)寄養家庭的功能,d)寄養機構的成果等方面之成效。

搜尋策略

我們搜尋了以下資料庫,包括:CENTRAL(Cochrane Library第3期,2006年)、MEDLINE(1966年1月至2006年9月)、EMBASE(1980年1月至2006年9月)、CINAHL(1982年1月至2006年9月)、PsycINFO(1872年1月至2006年9月)、ASSIA(1987年1月至2006年9月)、LILACS(截至2006年9月)、ERIC(1965年1月至2006年9月)、Sociological Abstracts(1963年1月至2006年9月)和2006年 National Research Register(第3期)。我們也聯繫此領域的專家以取得最近的研究。

選擇標準

針對寄養父母或照顧者,比較以行為或認知行為為基礎的訓練介入(以團體或一對一或兩種都有)與以無治療或等待名單為對照組的隨機或半隨機的試驗。

資料收集與分析

兩位回顧者分別評估試驗的品質且萃取數據。我們也與研究的作者聯繫,以了解額外的資訊。

主要結論

收納了6個試驗,共包含463位寄養照顧者。行為和認知行為的訓練介入,評估迄今,在被照顧的兒童的心理功能、行為問題的程度和人際運作方面的成果幾乎沒有顯現成效。和照顧者相關的結果也沒有顯示出在行為處理技能,態度和心理功能方面有效果的證據。關於寄養機構的分析,也沒有顯示出任何明顯成果。然而,這些研究的信賴區間很廣,因此詮釋其發現仍要很謹慎。

作者結論

目前還沒有證據顯示針對寄養照顧者的行為或認知行為訓練介入之效果。此領域進一步的研究應要被重視。

翻譯人

本摘要由成功大學附設醫院黃惠群翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

行為和認知行為的訓練介入,以協助寄養照顧者對困難行為的處理-目前仍沒有有力的證據提供寄養照顧者訓練被認為能增進關懷的態度和技能、幫助寄養照顧者更有效地處理寄養兒童的行為,且降低寄養照顧者的耗損。雖然訓練計畫蓬勃發展,但是很少有檢視其效果的評估性研究。這次回顧試圖確定認知行為的訓練介入的有效性,只收納了6個試驗,共包括463位寄養照顧者。結果顯示在被照顧的兒童、寄養照顧者及寄養機構的結果預後,幾乎沒有支持有效性的證據。