Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice

Objective To see whether a behaviourally based group parenting programme, d elivered in regular clinical practice, is an effective treatment for antiso cial behaviour in children. Design Controlled trial with permuted block design with allocation by date of referral. Setting Four local child and adolescent mental health services. Participants 141 children aged 3-8 years referred with antisocial behaviour and allocated to parenting groups (90) or waiting list control (51) I ntervention Webster-Stratton basic videotape programme administered to pare nts of six to eight children over 13-16 weeks. This programme emphasises en gagement with parental emotions, rehearsal of behavioural strategies, and p arental understanding of its scientific rationale. Main outcome measures Semistructured parent interview and questionnaires ab out antisocial behaviour in children administered 5-7 months after entering trial; direct observation of parent-child interaction. Results Referred children were highly antisocial (above the 97th centile on interview measure). Children in the intervention group showed a large redu ction in antisocial behaviour; those in the waiting list group did not chan ge (effect size between groups 1.06 SD (95% confidence interval 0.71 to 1.4 1), P < 0.001). Parents in the intervention group increased the proportion of praise to ineffective commands they gave their children threefold, while control parents reduced it by a third (effect size between groups 0.76 (0. 16 to 1.36), P = 0.018). If the 31 children lost to follow up were included in an intention to treat analysis the effect size on antisocial behaviour was reduced by 16%. Conclusions Parenting groups effectively reduce serious antisocial behaviou r in children in real life conditions. Follow up is needed to see if the ch ildren's poor prognosis is improved and criminality prevented.