Program Profile: Cognitive-Behavioral, Group-Mentoring Intervention for Children with Emotional and Behavioral Disturbances

This cognitive–behavioral, group-mentoring intervention was designed to improve child behavior and family functioning among 8- to 12-year olds with mental health disorders, and their primary caregivers. This program is rated Promising. Although there were statistically significant improvements on measures of social problem solving and behavior problems, there were no improvements on measures of social skills among children in the intervention group, compared with the control group.

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals/Target Population

The Cognitive–Behavioral, Group-Mentoring Intervention for Children with Emotional and Behavioral Disturbances program aimed to improve child behavior (externalizing and internalizing behavior problems, social problem solving) and family functioning (parenting stress, perceived social support, and attachment to parents) by using mentors to provide training, coaching, modeling, and reinforcement in social communication and problem solving. The program targeted 8- to 12-year-olds with emotional and behavioral disturbances, and their primary caregivers.

Program Components

This program was set within a rural community mental health center. Mentors met with children in a group format once a week for 3 to 4 hours over a 12-week period. During each  session, mentors used a combination of didactics and discussions related to social problem-solving and social-interaction skills followed by child-determined activities based on the specific group’s interests. All sessions occurred at the community center, and participants were transported to sessions by their mentors. Activities provided an opportunity to shape, rehearse, and reinforce appropriate interaction skills. Mentors used praise and a token economy to further reinforce appropriate use of problem-solving skills (children earned bonus points when they were observed engaging in positive behaviors).

Mentors also used live coaching and goal-directed, supportive conversations with children to encourage use of appropriate social-communication and problem-solving skills during sessions. At the end of each session, mentors spoke briefly with parents to discuss completed activities, the child’s behavior, and the extent of the child’s progress. Children were also provided with opportunities to engage in activities with their mentors outside of the community center, including going to the park, watching movies, and going to the library.

Key Personnel

Mentors were employed by the community mental health center and received a minimum of 24 hours of initial training covering program guidelines, positive reinforcement, live coaching, implementing token economies, and strategies for developing a positive mentoring relationship.

Program Theory

The focus of this cognitive–behavioral mentoring program is consistent with the social learning theory (Bandura, 1977). Additionally, the focus on improving the parent–child relationship is consistent with the emphasis accorded to the influence of familial relationships on developmental outcomes as well as on the child’s relationship with others within his or her social network, as in the ecological model of development (Bronfenbrenner, 1979, 1986).

Study

Jent and Niec (2009) assessed the effects of the cognitive–behavioral, group- mentoring intervention on multiple measures of functioning among 8- to 12-year-olds and their families. Participating children were referred for mentoring services at a rural Midwestern community mental health center. Families who could not commit to attending a 12-session, weekly group- mentoring program and/or whose children scored 2 or more standard deviations lower than the mean on the Peabody Picture Vocabulary Test–Third Edition were excluded from the study. Eligible families (n=86) were assigned randomly to either the intervention (n=45) or control condition (n=41). A total of six participants (three in the intervention and three in the control condition) withdrew from the study. Mentoring was provided to intervention youths in eight separate groups. Mentor-to-child ratios in these groups ranged from two mentors to eight children to two mentors to four children. Each session covered a particular topic and lasted about 4 hours. During each session, children received didactics related to social problem-solving and social-interaction skills and participated in group discussions. At the end of each session, one of the mentors completed a log, which tracked the activities and discussions completed, and the data administered and collected; activities related to the mentoring protocol were reported by mentors to have been completed 92 percent of the time. Youths in the control condition were placed on a 3-month wait list and received no contact with group mentors during the study period. 

Participants with data at pre- and post-intervention were included in the analyses (42 in the intervention group and 38 in the control group). The mentored group was 60 percent boys; 90.5 percent were white and 9.5 percent were Hispanic. The control group was 74 percent boys; 68.4 percent were white, 21.1 percent were Hispanic, and 10.5 percent were African American. There were no differences between intervention and control groups in child age or gender, child receptive language ability, number of hours of mental health services received in the last year, number of hours of mental health services received during the study period, or number of children prescribed psychotropic medication. Race and ethnicity significantly differed between participants in the intervention and control groups, with the intervention group having significantly more white participants than the control group. 

Outcome measures were completed by each participating child and the child’s maternal caregiver at baseline and at the end of the intervention. Children completed measures of parent attachment (Parent Scale of the Inventory of Parent and Peer Attachment) and social problem solving (Social Problem-Solving Inventory–Adolescents). Maternal caregivers completed the Behavior Assessment System for Children–Parent Report Form (BASC), the Parenting Stress Index–Short Form (PSI–SF), and the Social Skills Rating System (SSRS)–Parent Report Form. The BASC assessed the frequency with which children portrayed three domains of behavior including externalizing problems, internalizing problems, and adaptive skills; the SSRS–Parent Report Form assessed the frequency with which a child portrayed appropriate social skills and behaviors; and the PSI–SF assessed the level of stress a parent was experiencing in relation to her parenting and the sources of stress in the areas of personal parental distress, parent–child interactions, and child behavioral characteristics.

Fixed effects linear mixed models were used to test for effects of the intervention, with adjustments for the number of hours of mental health services received during the study period and child’s prescribed psychiatric medication status. Race and ethnicity, however, were not included in the final outcome analyses; these were reported not to have an effect on the results.

Mentors were employed by the community mental health center and  received a minimum of 24 hours of initial training covering program guidelines, positive reinforcement, live coaching, implementing token economies, and strategies for developing a positive mentoring relationship. Mentors also had weekly supervision sessions of a minimum of 30 minutes with a master’s-level clinician with substantial clinical experience in treating externalizing problems in children. Two of the mentors were completing graduate coursework in clinical social work or counseling and six were enrolled in a 4-year college (Jent and Niec 2009).

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Following are CrimeSolutions-rated programs that are related to this practice:

Mentoring for Youth Development

This practice provides youth with a positive and consistent adult or older youth relationship to promote healthy youth development and social functioning and to reduce risk factors. The practice is rated Effective in reducing delinquency and improving educational outcomes; Promising in improving psychological outcomes and cognitive functioning; and No Effects in reducing substance use.

Evidence Ratings for Outcomes

	Crime & Delinquency - Multiple crime/offense types
	Education - Multiple education outcomes
	Mental Health & Behavioral Health - Psychological functioning
	Mental Health & Behavioral Health - Cognitive functioning
	Mental Health & Behavioral Health - Social functioning
	Drugs & Substance Abuse - Multiple substances

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?