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A cluster randomized controlled trial of child-focused psychiatric consultation and a school systems-focused intervention to reduce aggression

Fonagy, P; Twemlow, SW; Vernberg, EM; Nelson, JM; Dill, EJ; Little, TD; Sargent, JA; (2009) A cluster randomized controlled trial of child-focused psychiatric consultation and a school systems-focused intervention to reduce aggression. Journal of Child Psychology and Psychiatry , 50 (5) 607 - 616. 10.1111/j.1469-7610.2008.02025.x. Green open access

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Abstract

While school-based anti-bullying programs are widely used, there have been few controlled trials of effectiveness. This study compared the effect of manualized School Psychiatric Consultation (SPC), CAPSLE (a systems and mentalization focused whole school intervention), and treatment-as-usual (TAU) in reducing aggression and victimization among elementary school children.Participants were 1,345 third to fifth graders in nine elementary schools in a medium-sized Midwestern city who took part in a cluster-level randomized controlled trial with stratified restricted allocation, to assess efficacy after two years of active intervention and effectiveness after one year of minimal input maintenance intervention. Outcome measures included peer and self-reports of bullying, bystanding, and mentalizing behavior and classroom behavioral observations of disruptive and off-task behavior.CAPSLE moderated the developmental trend of increasing peer-reported victimization (p < .01), aggression (p < .05), self-reported aggression (p < .05) and aggressive bystanding (p < .05), compared to TAU schools. CAPSLE also moderated a decline in empathy and an increase in the percent of children victimized compared to SPC (p < .01) and TAU conditions (p < .01). Results for self-reported victimization, helpful bystanding, and beliefs in the legitimacy of aggression did not suggest significantly different changes among the study conditions over time. CAPSLE produced a significant decrease in off-task (p < .001) and disruptive classroom behaviors (p < .01), while behavioral change was not observed in SPC and TAU schools. Superiority with respect to TAU for victimization (p < .05), aggression (p < .01), and helpful (p < .05) and aggressive bystanding (p < .01) were maintained in the follow-up year.A teacher-implemented school-wide intervention that does not focus on disturbed children substantially reduced aggression and improved classroom behavior.

Type: Article
Title: A cluster randomized controlled trial of child-focused psychiatric consultation and a school systems-focused intervention to reduce aggression
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/j.1469-7610.2008.02025.x
Publisher version: http://dx.doi.org/10.1111/j.1469-7610.2008.02025.x
Language: English
Additional information: This is the accepted version of the following article: Fonagy, P; Twemlow, SW; Vernberg, EM; Nelson, JM; Dill, EJ; Little, TD; Sargent, JA; (2009) A cluster randomized controlled trial of child-focused psychiatric consultation and a school systems-focused intervention to reduce aggression. J CHILD PSYCHOL PSYC, 50 (5) 607 - 616, which has been published in final form at: http://dx.doi.org/10.1111/j.1469-7610.2008.02025.x
Keywords: Childhood aggression, anti-bullying intervention, psychiatric consultation, mentalization, randomized controlled trial, LEARNING-ENVIRONMENT, PEER VICTIMIZATION, VIOLENCE, PREVENTION, METAANALYSIS, ADOLESCENCE, PROGRAMS, VICTIMS, MODELS, FORMS
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/133875
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