Connect©

Categories

Categories associated with best practice:

  • Children (ages 6-12) icon
  • Teens (ages 13-18) icon
  • Young Adult (ages 19-24) icon
  • Adult (ages 25-64) icon
  • Seniors (ages 65+) icon
  • Best Practices
  • Community/ Neighbourhood
  • Elementary School Icon 1
  • Health Care Setting
  • Healthy child development
  • Injury Prevention
  • Mental Health Icon 2
  • Personal health practices and coping skills
  • Preventing Violence Icon 1
  • Secondary School Icon 1

Determinants of Health: Personal health practices and coping skills, Healthy child development

Overview

Connect© is a 10-week principle-based program for parents and alternate caregivers of aggressive, antisocial and delinquent teens that integrates research on adolescent-parent attachment, adolescent development and effective parenting practices. The program focuses on the enhancement of the building blocks of secure attachment shown to affect child outcomes: parental reflective function, sensitivity, and adaptive dyadic affect regulation. The enhancement of competence in each of these domains supports parents to ‘reframe’ their adolescent’s behaviour and needs; modulate their emotional response to problem behaviour; and mindfully use parenting strategies to support their relationship with their adolescent while clearly setting limits and expectations. Connect© is based on extensive research findings confirming the importance of parent-youth relationships as a protective factor in healthy teen development, particularly in relation to aggressive, violent and antisocial behaviour. It also draws on evidence showing the effectiveness of attachment focused interventions for children with problem behaviour. Each session begins with a discussion of an attachment principle that helps parents understand attachment issues related to challenging interactions with their adolescent.

Several quasi-experimental evaluations of Connect have found it to result in reductions in externalizing and externalizing behaviours in youth. Some studies also found positive impacts on parents, such as improved parenting self-efficacy and confidence, improved parenting satisfaction and reductions in caregiver burden.

Connect© was developed in collaboration with the Maples Adolescent Treatment Center.

Primary Source Document

M Moretti, K Braber, I Obsuth, Connect: an attachment focused treatment group for parents and caregivers. Simon Fraser University

Contact information of developer(s) and/or implementer(s)

Marlene Moretti, PhD

Department of Psychology

Simon Fraser University

8888 University Drive

Burnaby, British Columbia,

CANADA V5A 1S6

Phone: 778 782 36

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Increase the protective quality of the parent-teen relationship.
  • Interpersonal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Strengthen attachment security between adolescents and their caregivers.
  • Interpersonal level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.
Reduce the risk for mental health and aggressive behaviour problems.
  • Individual level
People living in conditions of disadvantage are not explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

  • Mental Health

Risk Reduction

  • Prevent injury
  • Prevent violence

Specific Activities of the Intervention

  • Group process/program

Priority/Target Population for Intervention Delivery

Life Stage

  • Children (age 6-12 years)
  • Youth (age 13-18 years)
  • Young adult (age 19-24 years)
  • Adults (age 25-64 years)
  • Seniors (age 65+ years)

Settings

Educational Settings

  • Secondary/Middle school
  • Elementary school

Community Setting

  • Community/neighbourhood
  • Health care setting

Outcomes

Outcomes and Impact Chart
Level of ImpactDescription of OutcomeEquity Focus
Interpersonal LevelStudy 1 (20 parents, waitlist control; 12-month follow-up): During the waitlist period, small but non-significant decreases were noted in youths’ total (d =.31; p <.096) and externalizing (d = .35; p< .065) problems. In contrast, on the Child Behavior Checklist (CBCL) parents reported medium to large and significant reductions in youths’ total problems (F(1,19) = 10.92, p <.005, d = .64), including externalizing problems (F(1,19) = 8.11, p< .011, d= .68). More specifically, significant small to moderate reductions emerged in youths’ rule-breaking (F(1,19) = 7.6, p< .014, d =.42) and aggressive behaviour (F(1,19) = 7.9, p <.012, d = .27), as well as in their social problems (F(1,19) =6.50, p <.020; d =.35). With respect to the DSM-IV scales of the CBCL, significant small to moderate decreases were found in youths’ conduct problems (F(1,19) =6.35, p <.022, d = .46) and oppositional defiant problems (F(1,19) =6.72, p <.019, d =.32). At 12-month follow-up, no parents report a loss in the magnitude of post-treatment improvements. Additional small but significant declines emerged in youths’ total problems (F(1,16) =6.78, p <.019, d= .24). Specifically, parents reported further small to moderate significant decreases in conduct problems (F(1,16) = 5.14, p< .039, d =.24) and marginally fewer rule-breaking behaviours (F(1,16) =4.03, p <.062, d =.08), and social problems (F(1,16) =3.51, p <.079, d =.09).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelParents reported moderate and significant improvements in their teens’ ability to regulate affect (B=-.373, p < .001, d= .46) and reflect on their emotional experiences (B =.293, p< .003, d =.43), and small but significant decreases in their teens’ suppression of affect (B=-.194, p < .031, d =.29).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelStudy 1: During the waitlist period, parents did not report significant changes in parenting satisfaction (d =.09) or sense of efficacy (d = .08. In contrast, caregivers reported medium and significant increases in perceived parenting satisfaction (F(1,19) = 2.9, p <.019, d = .45) and large significant increases in parenting efficacy (F(1,19) =16.89, p< .001, d = .86) following treatment. At 12-month follow-up, no parents report a loss in the magnitude of post-treatment improvements.Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelStudy 1 (20 parents, waitlist control; 12-month follow-up): During the waitlist period, parents did not report significant changes in teen internalizing problems (d =.04). In contrast, on the Child Behavior Checklist (CBCL) parents reported medium to large and significant reductions in youths’ internalizing (F(1,19) = 10.78, p <.005; d =.63) problems. More specifically, significant small to moderate reductions emerged in their anxiety/ depression (F(1,19) = 5.5, p <.032, d = .28). With respect to the DSM-IV scales of the CBCL, significant small to moderate decreases were found in affective problems (F(1,19) = 10.33, p < .006, d = .45), and anxiety problems (F(1,19) =4.7, p <.045, d= .32). At 12-month follow-up, no parents reported a loss in the magnitude of post-treatment improvements. Additional small but significant declines emerged in youths’ total problems (F(1,16) = 6.78, p <.019, d= .24). Specifically, parents reported further small to moderate significant decreases in depression (F(1,16) = 5.46, p <.034, d =.34), and anxiety problems (F(1,16) = 6.89, p <.018, d =.31).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelStudy 2: Parents reported significant reductions in symptoms of ADHD (B=-.297, p <.003, d= .71) and Dysthymia (B=-.284, p <.003, d =.43).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Individual LevelStudy 2 (pre-post, 17 communities, N=309 parents): parents reported large and significant increases in parenting satisfaction (B = .331, p< .001, d = .74) and perceived efficacy (B =.354, p < .001, d = .71). Large and significant decreases in caregiver strain were also observed in the domains of objective strain (¬=-.622, p < .001, d = .93), subjective externalized strain (B=-.402, p < .001, d = .98), and subjective internalized strain (B=-.649, p< .001, d=.70).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Interpersonal LevelStudy 2: Moderate to large significant increases were noted in parents’ reports of their teens’ social participation (B= .477, p <.001, d =.62), quality of relationships (B =.459, p <.001, d =.37), school participation (B =.314, p <.007, d= .64) and global functioning (B =.418, p < .001, d =.64).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.
Interpersonal LevelStudy 2: Parents reported moderate to large significant reductions in total problems (B=-.235, p< .001, d = .59) and externalizing problems (B=-.295, p< .001, d = .56), and internalizing problems (B=-.171, p < .014, d =.34). More specifically, moderate and significant reductions were evident in symptoms of CD (B=-.169, p <.022, d =.36), and ODD (B=-.428, p <.001, d =.65. Parents also reported large and significant reductions in their teens’ aggression toward them (B=-.293, p < .001, d = .74) as well as their own aggression toward their teens (B=-.188, p< .001, d =.94).Reported outcomes do not distinguish findings specific to people living in conditions of disadvantage.

Adaptability

Implementation History

  • Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.

Expertise Required for Implementation within the Context of the Intervention

  • Requires specialized skills that are easily available within the context - The intervention requires the participation of personnel with advanced skills (e.g. medical doctors, epidemiologists, social workers) but that are easily available within the intervention context.

Are there supports available for implementation

Yes. Training, supervision, and certification of leaders

Are there resources and/or products associated with the interventions

Yes. Connect Parent Group – Adolescent Edition (for parents of 13-18 year-old youth), Connect Parent Group – Pre-Adolescent Edition (for parents of 8-12 year-old children), Connect Parent Group – Supplement for Supporting Parents of Youth with Major Mental Health Disorder, and program pamphlets.