E  M  P  A  T  H  Y  =  S  A  F  E  T  Y

Research Study Leading to AVERT Project for Parents

I. Introduction
The San Luis Obispo County Probation Department, in serving its obligations and in honoring its commitment to enhance the safety and quality of life for all children and families within the county initiated a clinically based treatment program for those parents and care givers referred by the Superior Court for violations of any type of child abuse and/or neglect, the Child Abuse Prevention Program (CAPP).  The Probation Department contracted with Leonard Manzella, LCSW, to provide effective treatment, and parenting and communication skills education to ensure the safety of the minors involved in active cases of child abuse and/or neglect, and to promote permanent changes to prevent such incidences of abuse and neglect in the future. 

The treatment program was initiated in November, 2002.  This report has been prepared to describe the initial outcome measures of the program designed and provided by Leonard Manzella.
   

II. Objectives
This report has been prepared as the first and second descriptions of outcome measures of the CAPP treatment program instituted by the San Luis Obispo County Probation Department.  Should funding be continued for this program, this report will also serve as one of other subsequent interim reports yet to be produced as a means of tracking the success of the program.

This report identifies shifts in cognitive distortions and behavioral referents over time among all participants in the treatment program who have attended 10 or more program sessions provided by the Probation Department.  The shifts identified will be interpreted as movement toward or away maladaptive aspects of parenting.  The treatment program can only be interpreted a success with movement being identified away from maladaptive cognitive distortions and behavioral referents.
   

III. Method
The data upon which this report is based was derived from all 15 participants in the CAPP treatment program who have attended 10 or more treatment sessions in July, 2003, and an additional five participants who had completed 10 sessions by the end of October, 2003.  Each participant responded to the How I Think (HIT) questionnaire upon entry into the program.  Each participant also responded to the same HIT questionnaire after they had completed 10 sessions; no one completed the questionnaire immediately after attending a group session, all questionnaires were completed prior to the start of a session.  A longitudinal research design is employed herein so that pre and post test periods will be compared and changes identified and interpreted.

Because the data in this report is based on every potential participant, and because there is no control sample of individuals matched who are not attending the treatment groups (due to budget constraints), the changes observed here are real changes and thus no significance testing was done.  The HIT questionnaire was designed to measure maladaptive traits identifying four subscales of cognitive distortions and four subscales of behavioral referents as follows:

 
The HIT questionnaire is used here in an unconventional manner.  The HIT instrument was developed as an assessment and treatment planning tool, it is the objective instrument employed here to identify movement toward or away maladaptive cognitive and behavioral patterns among the program participants.

Respondents identify their level of agreement with 54 statements.  A six point rating system is used including “Agree Strongly, Agree, Agree Slightly, Disagree Slightly, Disagree, and Disagree Strongly.”  Each response is rendered a rating score that ranges from six (Agree Strongly) to one (Disagree Strongly) as discrete variables.  The HIT instrument was designed and scored in a manner where higher scores on the eight different subscales denote higher levels of maladaptive cognitive distortions and behavioral referents, and lower scores denote fewer maladaptive traits.  Thus, shifts between pre test to post test scores are the focus of this research.  Shifts to higher scores denote increased maladaptive functioning, and conversely, shifts to lower scores from pre test to post test periods denote improved functioning.
   

IV. Analysis of Findings
For the purposes of this report, it was determined that the post test data would be produced for all program participants who have attended at least 10 sessions.  Thus, each participant had remained in the program for a minimum of five months.  The determination that 10 sessions should serve as the benchmark was based on clinical determinations.  The mean number of sessions among the participants upon which the data is reported is 11.5, or nearly six months or more (depending on absences) of participation in the CAPP program.
   

The Cognitive Distortions Scale
The HIT questionnaire identifies clinically significant characteristics of maladaptive thinking.  Among the program participants, scores have shifted negatively from pre to post test periods for each of the four cognitive distortion subscales from between 0.19 and 0.08 indicating a shift in thinking patterns toward more adaptive thought processes, and a reduction of distortion.

-- Mean Aggregate Rating Scores --

   
The Behavioral Referents Scale
The HIT questionnaire identifies clinically significant recognition of maladaptive behaviors.  Among the program participants, scores have shifted negatively from pre to post test periods for each of the four behavioral referent scales from between 0.23 and 0.15 indicating a perceived shift toward more adaptive behaviors.

-- Mean Aggregate Rating Scores –

  
Among the 54 statements rated for agreement by the respondents, eight achieved unusually high shifts in pre test to post test scores of 0.40 points or more.  All eight of these statements received lower post test rating scores.  There were no statements which achieved unusually high positive shifts in ratings from pre test to post test periods.
   

HIT Statements With Pre to Post Test Mean Score Changes of -0.40 or Greater

   
V. Conclusions
The results of the data reported on herein must be interpreted as directional rather than definitive.  Overwhelmingly, the shift in pre test to post test scores with the HIT statements denote movement toward more adaptive functioning among the program participants who have completed 10 or more psychodrama sessions.  It is notable that among all of the Cognitive Distortion and Behavioral Referents scales, that shifts are away from maladaptive cognitive and behavioral characteristics.  More globally, there are greater shifts toward more adaptive functioning on the Behavioral Referents Scale versus the Cognitive Distortion Scale.

The statements which received the largest shifts in pre to post test scores are:

·         I can’t help losing my temper a lot.

·        When I get mad, I don’t care who gets hurt.

The two statements identified above, being among the statements with the largest negative shifts in agreement (-0.55 and -0.50) may indicate that the program is most effective at improving communication skills.

Overall, the findings of this research indicate that the clinically based treatment and education program currently adopted by the San Luis Obispo County Probation Department is deriving positive effects among the program participants.  Thus, it may be inferred that this treatment program is resulting in a safer and healthier community.