Briana Wesclitz

Literature Review

Behavioral disorders are an ongoing problem in today’s society especially with children.

Some of these disorders include oppositional defiant disorder, conduct disorder, and attention-

deficit/hyperactivity disorder. emotional disorders such as anxiety and depression can cause

children to act up and have behavioral problems. One of the reasons a group for children with

behavioral problems is needed is because if it goes untreated, then as adults the children continue

to have behavioral problems. One study looked at different kinds of treatment groups for kids

who have behavioral disorders or problems (Webster-Stratton & Hammond 1997). These groups

were a parent training group, a child training group, a combined parent and child training group

and a waiting-list control group. The participants, 97 children with their families, we assigned

randomly to these groups. The children were ages 4-8 years old. Assessments were done after

treatment to see if results were significant. According to the assessments, there indeed was

significant improvements in behavior when comparing the control group to the treatment groups.

These improvements in behavior included conflict managing skills and problem solving. There

was also a one year follow up assessment that found that the children caused less problems at

home. The combined parent and child training group showed to have the most significant

improvement both in the assessments right after the treatments and in the one- year follow up.

Some families do not have a support system that others may have. Single parents may

especially have a hard time trying to get their children to behave because they do not have the

backup or support that two parents may have. Even though the study discussed above showed

positive results with both parents, one may question if it works for single parent since they may

not have the same support system. Another study that showed positive effects after behavioral
therapy focused on single parent groups (Roberts & Mazzucchell 2006). The researchers

specifically wanted to see if the role of social support deterred the behavioral management

programs from working. Participants were randomly put into two different groups. Both these

groups went through a 6-week program but one group received extra social support intervention.

A post treatment and 6 month follow up analysis were taken to see if improvements were made

from treatment. Researchers assessed parent behavior, child deviance, social support, and

parental depression. Both groups improved and even though one group received more social

support intervention than the other, there was not a different in the amount of improvement.

They equally improved which shows that single parents and their children can equally benefit to

group treatment just as families with both parents do. The single parents reported back that they

had social support from friends. In terms of social support this seemed to be as equal as having a

partner to parent with.

Not only will therapy benefit the child, it will also benefit the parent or parents. A study

with Forty-eight children with developmental disabilities analyzed the behavior of the child but

also the effects from treatment on the mother. The children were randomly put into an

intervention group or a wait-list control group. Measures were completed by parents to determine

stress levels and parenting styles. Researchers then observed the parents interact with their

children after treatment. The researchers and parents both came to the conclusion that the child

had fewer behavioral problems. It also was reported that the stress levels were decreased for the

mothers and parenting styles were improved. There was a follow up six-month study and all the

positive effects were still present. This study shows that mothers can also benefit from group

therapy because their stress will go down and parenting skills could potentially get better. With

better parenting skills and decreased stress, the child may be more inclined to behave.
 One common behavioral problem in children is ADHD. Children who have ADHD that

goes untreated may have a higher risk of becoming homeless. This will only worsen their

disorder and close many opportunities for them in life. The need for behavioral treatment is

necessary. One study focused on 6- to 12-year-old boys of white ethnicity with ADHD (Murillo

& Ramos-Olazagasti 2016). The researchers followed up with these boys 33 years later to assess

the risk of homelessness. There were no treatments done on these boys during those years.

Children without ADHD had a 4.4% risk of homelessness while children with untreated ADHD

had a 23.7% increased risk of homelessness. This study concludes that treatment is needed to

prevent negative outcomes for those with behavioral problems, specifically ADHD. Another

study related to homelessness and behavioral problems focused on psychological adjustment of

159 homeless children (Masten & Miliotis 1993). Researchers compared them to a sample of 62

low-income children living at home. The children were ages 8-17. The homeless children were

found to have more stress, and disrupted schooling when compared to low income children

living at home. This of course can advance into behavioral problems. The behavior problems

found in the homeless children studied were found to be above normal. A common behavioral

problem assessed in this study was antisocial behavior. The results showed that low income

children and homeless children had about the same risk in obtaining more severe behavioral

problems. Even though this is true, the increased stress and disrupted schooling may hold

homeless children back from improving their behaviors. There is a need for group programs for

low income or homeless people and one place that could greatly benefit from it is the Teresa

Shelter.

The Teresa Shelter is a shelter that is specifically for women and children. Residents are

expected to follow rules and do chores if they want to stay there. If there are any conflicts with
that then they are asked to leave. Some women are asked to leave if they are not able to keep

their children from misbehaving. This puts the mother and children back on the street instead of

in a sheltered place. The shelter must keep their strict rules in order to keep the place running.

There cannot be exceptions for the resident because it would be unfair to others. Instead of

making exceptions for these mothers the Shelter could help them by forming a group. As

discussed in the literature review, low income and homeless children have an increased risk of

having their behavioral problems become more sever due to the lack of available treatment

(Masten & Miliotis 1993). This group would help the mothers discipline their children in

productive ways.

This group will be offered to the residents at the shelter. Specifically, for mothers and

their kids with behavioral problems. Since the Teresa shelter is a women and children shelter

only women will be allowed to be in the group. Men may make some of the women

uncomfortable since a lot of the women at the shelter have experienced abuse from men. The

leader, a social worker with a masters, must be a woman to continue to make the women feel

safe in the shelter. Since the children will be in the group there are potential obstacles when it

comes to keeping them focused. Crayons and paper will be given to the children while the social

worker is specifically talking to the parents. When it is time for the social worker to talk to the

children or both the children and parents, snacks will be given to those who listen. This will

hopefully cause the children to listen because they know they will get a reward if they do.

Before the resident can live at the shelter they must go through paper work. In this paper

work there will be a questionnaire about how their child reacts to discipline or how they handle

disciplining their children. There also will be an assessment on parenting styles and parental

stress similar to ones in the studies discussed in the literature review (Roberts & Mazzucchell
2006). If the mother and child fit the criteria, then the ground agreement is that they both will be

required to attend the group. Since the group members will be from the Teresa shelter, the group

will consist of the homeless population. There is a need for programs like this for the homeless

population. It will be a closed group since it is only open to residents of the Teresa Shelter. The

group will never be too big since there is a capacity limit in the shelter. Group will take place at

the shelter in the community room. They will meet twice a week on Monday and Friday. It will

go for one hour starting at 11am to 12pm. Since this is a new group this will go one for two

months just to see if it is helping the mothers and worth continuing. It will start in January and go

till the end of February. The group members will not need to prepare too much expect for

bringing a notebook and pen to write notes down. They should come with an open mind and be

ready to listen to the social worker.

One thing mentioned in the literature review was the significant effects of parent and

child treatment groups (Webster-Stratton & Hammond 1997). Compared to just the child

treatment group, the parent group, and the control group, it overall had the most improvements in

behavior. For that reason, the group will be a parent – child group. This way there is the least

chance of the resident being asked to leave due to the children’s behavior. Adjustments will be

made for this population since there is one parent instead of two living in the shelter. These

adjustments will be the parenting styles since some require two parents. Staff will be required to

attend these sessions as well to help the mothers along the way. There are times when staff

watches the kids while their mother is doing their chore. Staff attending the group can help them

know how to deter the child from acting out.

One parent in a treatment group still presents itself as just as effective as a group with

two parents (Roberts & Mazzucchell 2006). The social worker can be the support system that
some families lack. Trust and support can be established by helping them understand that they

are not alone in the situation. The rules of complete honesty and rules of confidentiality would be

discussed. Nothing leaves the group and the social worker cannot help the residents in the best

way if they are lying. The social worker could let the residents know that they can come to the

group with anything. Another way to gain trust and support is just by letting the residents know

that the everyone makes mistakes. Since parenting is important to how the child develops, some

residents may be afraid to take risks in their parenting. The social worker needs to tell them that

there is no such thing as a perfect mom. They need to be assured that parenting that does come

with negative outcomes will be address and fixed in the treatment group. The social worker will

prepare them by going over some practice exercises with the child and parent. These exercises

will focus on trying new parenting methods with the child.

The goal of this group is to help mothers with their kids who have behavioral problems.

Going more into detail, the goal is to reinforce desirable behaviors, discourage unwanted

behaviors, and improve parent-child interactions. Some of the things the parent will be learning

is how to set time-outs, how to manage rules, and how to resist from giving their child what they

want. This group can help prevent mothers from being asked to leave the shelter. It also will

help with interactions between the parent and child as shown in literature review studies. It gives

them a foundation for raising their child. It can help support positive behaviors that the child will

continue to do as they grow older. The group setting will give the women a support setting.

These women live with each other and can understand each other more by spending this

treatment time together. The Teresa shelter provides a case manager for each resident as the

shelter. The goals of this treatment group will be evaluated by the case manager. They will check
in with the resident to see how they are doing and what improvement they see in their self and in

their child.

Ethical situations include coming up with the best ways to teach these women. If the

social worker teaches the group a method that does not correlate with the shelter rules, then there

is a chance the resident could lose her bed at the shelter. For example, pinching is absolutely not

allowed at the shelter. The social worker needs to take into account what methods work for the

family without putting them at risk of leaving the shelter and going back in homelessness. If all

goes well then the parent-child group will prevent families from leaving the shelter and improve

the child and parent’s lives.

Sources

Dadds, M. R., & McHugh, T. A. (1992). Social support and treatment outcome in behavioral family
therapy for child conduct problems. Journal of Consulting and Clinical Psychology, 60(2), 252-
259.
http://dx.doi.org/10.1037/0022-006X.60.2.252

Masten, A. S., Miliotis, D., Graham-Bermann, S. A., Ramirez, M., & Al, E. (1993). Children in homeless
families: Risks to mental health and development. Journal of Consulting and Clinical Psychology,
61(2), 335–343. doi: 10.1037//0022-006x.61.2.335

Murillo, L. G., Ramos-Olazagasti, M. A., Mannuzza, S., Castellanos, F. X., & Klein, R. G. (2016).
Childhood Attention-Deficit/Hyperactivity Disorder and Homelessness: A 33-Year Follow-Up
Study. Journal of the American Academy of Child & Adolescent Psychiatry, 55(11), 931–936.
doi: 10.1016/j.jaac.2016.07.772

Roberts, C., Mazzucchelli, T., Studman, L., & Sanders, M. R. (2006). Behavioral Family Intervention for
Children With Developmental Disabilities and Behavioral Problems. Journal of Clinical Child &
Adolescent Psychology, 35(2), 180–193. doi: 10.1207/s15374424jccp3502_2
Webster-Stratton, C., & Hammond, M. (1997). Treating children with early-onset conduct problems: A
comparison of child and parent training interventions. Journal of Consulting and Clinical
Psychology, 65(1), 93–109. doi: 10.1037//0022-006x.65.1.93