Long-Term Effects of Group Versus Individual Intervention Formats on Aggressive Children’s Externalizing and Delinquent Behaviors

Introduction: Prior research suggests that under some conditions, interventions that aggregate high-risk youth may be less effective, or at worse, iatrogenic. In a first rigorous test of the effects of group versus individual delivery of evidence-based intervention for aggressive children, 360 fourth-grade children (67% male) were randomly assigned by school to Group Coping Power (GCP) or Individual Coping Power (ICP) (Lochman, Dishion et al., 2015), using only the CP child component. Growth model analyses revealed children in both conditions reduced teacher and parent reported externalizing behavior problems and internalizing behavior problems by the end of the one year follow up. However, the degree of improvement in teacher-reported outcomes was significantly greater for ICP children. Despite this, group formats have been considered to have considerable practical utility for delivery of preventive interventions, and thus it has been crucial to understand child and therapist factors that predict which aggressive children can profit from group intervention and which do not.

Methods: To address these core research questions, Lochman, Dishion and colleagues (2017) coded leader and participant behavior in 938 video-recorded GCP sessions from this sample. The behavioral coding system used in the analyses included two clusters of behaviors for children (positive; negative) and two for the primary group leaders (group management; clinical skills). Growth spline models suggested that high levels of children’s negative behaviors predicted increases in teacher and parent rated aggressive and conduct problem behaviors during the one-year follow-up period in the three of the four models. Therapist use of clinical skills (e.g., warmth, nonreactive) predicted less increase in children’s teacher-rated conduct problems. In the planned presentation we will extend the prior findings in three key ways.

Results: First, we will examine how condition (GCP vs ICP) may have long-term effects on youths’ slopes of externalizing behaviors through a four-year follow-up when the youth are in high school. Second, we will also determine how condition may affect other indicators of serious conduct problems, namely youth self-report of delinquency and substance use; preliminary analyses do suggest that children seen in ICP have lower rates of general delinquency than do children seen in GCP. Finally, we will examine whether group leaders’ and youths’ in-session behaviors predict these long-term delinquency and externalizing outcomes.

Conclusions: These findings highlight the importance of clinical training in the effective delivery of evidence-based practices, particularly when working with high-risk youth in groups.