Improving outcomes in mental health for children and families: A study of Enhanced Stepping Stones Triple P

INTERVENTION: Enhanced Group Stepping Stones Triple P First, participants receive Group Stepping Stones Triple P (Level 4) which comprises 6 x 2‐hour group sessions, held weekly at Lady Cilento Hospital or other suitable location. The sessions are designed for parents of children with special needs and guide them in using strategies to promote a positive relationship with their child, encourage desirable behavior, teach new skills and behaviors, and manage challenging and disruptive behavior. Sessions involve didactic teaching, viewing DVD segments, some role play, and completion of exercises in the provided participant workbook. Participants also receive 3 x 30‐minute phone consultations, over 3 weeks. The phone consultations are designed to help parents put the learned content into practice at home. They involve the facilitator guiding parents to self‐assess their homework task completion and set their own goals for the coming week. Second, participants receive an additional 3 x 90‐minute group sessions, over 3 weeks, which focus on using cognitive behavioural coping skills. These additional sessions are designed to address parental mood disturbance and focus on stress management and cognitive coping skills for managing depression, anxiety, stress and anger. Sessions involve didactic teaching, some role play, and completion of exercises in the provided participant workbook. Participants receive 2 information workbooks, "Stepping Stones Triple P Group Workbook" and "Every Parent's Supplementary Workbook. Module 2: Coping Skills", both of which provide content, exercises for completion and homework tasks. The group sessions include viewing segments from the DVD "Stepping Stones Triple P: A survival guide for families with a child who has a disability". Group sessions are conducted face‐to‐face by nurses and/or psychologists who have been trained to criterion and my be assisted by trained psychology graduates. The facilitators will also conduct the home‐phone consultations. Participants who miss sessions may receive a copy of the DVD to watch at home, instructions on workbook exercises to complete, and a follow‐up phone call from their facilitator to go over workbook exercises and ensure the session has been sufficiently completed. CONDITION: Anxiety Attention‐Deficit/Hyperactivity Disorder autism spectrum disorder Behavioral disorders Depression PRIMARY OUTCOME: Change to parent anxiety problems as assessed by the Adult Self‐Report (ASR). Change to parent avoidant personality problems as assessed by the ASR Change to parent depressive problems as assessed by the Adult Self‐Report (ASR). ; Change to parenting practices and parental adjustment as assessed using the Parenting and Family Adjustment Scales (PAFAS) Change to relationship satisfaction as assessed by item 6 of the Relationship Quality Index (RQI) INCLUSION CRITERIA: Parents participating in "Improving outcomes in mental health: A longitudinal clinical study of vulnerable families" who score above the (sub)clinical threshold on the ASR at baseline (indicating possible mental health problems) are eligible for this trial. Participants of the longitudinal study are adults and children from families that have been referred to the Child Development Program in Children's Health Queensland, Health and Hospital Service. SECONDARY OUTCOME: Change to child (school‐age children) autistic traits as assessed by the Social Responsiveness Scale Short Form (SRS ‐Short) (This is a primary outcome) Change to child anxiety problems as assessed by the Child Behavior Checklist (this is a primary outcome) Change to child attention deficit/hyperactivity problems as assessed by the Child Behavior Checklist (this is a primary outcome) Change to child autism spectrum problems as assessed by the Child Behavior Checklist (this is a primary outcome) Change to child conduct problems as assessed by the Child Behavior Checklist (this is a primary outcome) Change to child depressive problems as assessed by the Child Behavior Checklist (this is a primary outcome) Change to child oppositional defiant problems as assessed by the Child Behavior Checklist (this is a primary outcome) Change to child school achievement measured via parent‐report of school awarded grades achieved in English, mathematics, science, humanities and social sciences or via parent estimate of achievement (above average, average, below average) for school‐age children who do not receive formal grades. Change to child social problems as assessed by parent reported occurrence of child being bullied in previous month and frequency of child being rejected by peers in the previous month. Change to level of conflict between partners over child‐rearing as assessed using the Parent Problem Checklist. Change to number of parent‐reported organized child leisure activities engaged in over the previous month (e.g. scouts, sports, music lessons, religious classes). Change to parent antisocial personality problems as assessed by the Adult Self‐Report (ASR) (this is a primary outcome) Change to parent attention deficit/hyperactivity problems as assessed by the Adult Self‐Report (ASR) (this is a primary outcome) Change to parent reported duration of child screen‐time (Rarely or never, Less than one hour per week, 1‐3 hours per week, 4‐7 hours per week, 1‐2 hours per day, 3‐6 hours per day, More than 6 hours per day)