Principal Investigator: JoAnne L. Pedro-Carroll
Level of Intervention: Selected
Target Population: Children with separated or divorced parents.
References: Alpert-Gillis, Pedro-Carroll, & Cowen (1989); Pedro-Carroll, Alpert-Gillis, & Cowen (1992); Pedro-Carroll & Cowen (1985).
Theory (Risk & Protective Factors Targeted):
Stressful life events increase the risk of adjustment problems and research has documented the negative psychological effects of divorce for some children. Children from divorced families have been found to have poorer teacher-rated adjustment, skill-development, and school performance (Guidubaldi, Clemshaw, Perry, & Mcloughlin, 1983). They have also been described as more aggressive compared to children from intact families and less popular with peers (e.g. Emery, 1982). These findings emphasize the need for preventive interventions with this population.
Description of Intervention:
The Children of Divorce Intervention Program (CODIP) is a school-based preventive intervention. The original program (Pedro-Carroll & Cowen, 1985) was based on a modified version of the Childrens Support Group (CSG, Stolberg & Mahler, 1994), the child component of the Divorce Adjustment Project (DAP; Stolberg & Cullen, 1983). The program consisted of 10 sessions that were co-lead by group leaders. The program emphasizes support and skill building. Children are provided with an opportunity to discuss their thoughts and feelings about their parents divorce (3 sessions) and taught problem solving skills (3 sessions) and anger management skills (3 sessions) to enhance adaptive coping with their reactions to the event. A final session was used to conduct an evaluation with the children regarding their experiences in the group. The Pedro-Carroll et al. (1986) version of the program was very similar to the original program but consisted of 11 sessions with one session added to focus on building childrens self esteem. Alpert-Gillis, Pedro-Carroll, & Cowen (1989) modified the CODIP so that it was more appropriate for a younger (2nd and 3rd graders) urban, low-income, population that was more ethnically diverse. The format was expanded to 16 sessions, materials were adapted, and exercises were added that addressed the developmental and sociocultural realities of the families. The over-arching goals of the program (foster group support, facilitate discussion of divorce-related feelings, promote understanding and reduce misconceptions, teach problem solving skills, enhance positive self and family perceptions) remained the same as previous version. Certain issues were addressed in more depth (e.g. reunion fantasies, relations with non-custodial parents) and more visual-aids were employed. In one of the most recent versions of the program, Pedro-Carroll, Alpert-Gillis, and Cowen (1992) took the 16-session version of CODIP used in Alpert-Gillis et al. (1989) and adapted it for an older (4th through 6th grade) sample of urban, low-income students.
Pedro-Carroll & Cowen (1985)
The subjects (33 girls, 42 boys) were 4th through 6th grade, white, middle-class children. They were recruited by sending letters to all of the students enrolled in 4th through 6th grade in 4 suburban schools. There were 41 children in the intervention and 34 in the delayed intervention control group. Parents of the subjects had been separated or divorced for an average of 23.6 months (range 1-84 months).
The total subject pool was randomly assigned to condition within the schools. Groups were matched for sex, grade, length of time since separation, and 8 pre-adjustment measures.
The intervention and control groups were not equivalent on the Acting Out factor of the Classroom Adjustment Scale (CARS; Lorion, Cowen, & Caldwell, 1975) and the Good Student factor of the Health Resources Inventory (HRI; Gesten, 1976) at pre-test. Prior to the intervention, control subjects were significantly more likely to be described as acting out and a poor student by teachers than treatment subjects. These group differences were not controlled in subsequent analyses.
The treatment group improved significantly more than controls on 8 of 10 scales of the CARS and the HRI. Teacher ratings were significant on the Shy-Anxious (p<.001), Learning Problems (p<.05), Adaptive Assertiveness (p<.05), Peer Sociability (p<.001), Follows Rules (p<.01), and Frustration Tolerance (p<.05) scales. Childrens total score on the Stait-Trait Anxiety Inventory for Children (STAIC; Spielberger, 1973) indicated that intervention subjects reported significant reductions in anxiety symptoms compared to controls (p<.02). Parents of intervention subjects described their children as significantly better adjusted on the total score of the Parent Evaluation Form (measure created for this study) compared to parent ratings of control subjects (p<.001).
Alpert-Gillis, Pedro-Carroll, & Cowen (1989)
The intervention subjects (52 program subjects, 52 divorce controls, & 81 intact comparisons) were 2nd through 3rd grade, urban children. The sample was 69% Caucasian, 23% African-American, 5% Hispanic, and 3% other. Twenty-three percent of the sample was at or below poverty level (1989). Girls made up 46.5% of the sample. Subjects were eligible if their parents were separated or divorced and they were not currently in treatment. Treatment subjects were recruited through referrals by school professionals, and with program announcements. Control and comparison subjects were recruited by sending letters describing a study about child development and family life.
Quasi-experimental design, matched comparisons with assessment at pre and post-intervention. The three groups were proportional by sex, grade, and racial composition.
Group differences at pre-test reflected poorer adjustment for children of divorce on the PEF, the two T-CRS sum scores, and the 7 T-CRS factor scores compared to children from intact families. There were no significant differences between the two groups of children from divorced families.
Intervention children reported significantly more positive feelings about their families and improved coping skills on the Childrens Divorce Adjustment Scale (CDAS; an adaptation of Sterling, 1986) compared to controls (p<.001). Parents of children who participated in CODIP described their children as significantly better adjusted on the total score of the PEF compared to parent ratings of control subjects (p<.001). Teachers described intervention students as significantly more competent than control children (p<.01). Specifically, they rated them as more assertive (p<.01), socially skilled with peers (p<.01), and better able to tolerate frustration (P<.04) on the T-CRS.
Pedro-Carroll, Alpert-Gillis, & Cowen (1992)
The sample consisted of 188 (110 boys, 78 girls) 4th through 6th grade students from 9 schools (57 intervention, 38 non-program divorce controls, 93 comparisons from non-divorced families). The groups were matched by grade and gender. Fifty-six percent of the sample was Caucasian, 30% African-American, 10% Hispanic, 3.6% Asian, and .4% Native American. The sample represented a range of socioeconomic levels. Subjects were eligible if their parents were separated or divorced, not currently in treatment, and had no severe emotional problems. Treatment subjects were recruited through referrals by school professionals, and with program announcements. Control and comparison subjects were recruited by sending letters describing a study about child development and family life.
Quasi-experimental design, matched comparisons with assessment at pre and post-intervention.
The intervention, control, and comparison groups were compared at pre-test. On four out of six variables (STAIC, PEF, T-CRS competence sum, T-CRS problem sum) there were significant group differences. In each case, the CODIP children (intervention group) had significantly poorer adjustment than the divorce control group and the intact comparison group.
At post-test, significant group differences were found that favored the CODIP participants. Children who received the intervention reported significantly more positive feelings (p<.003) about their families and improved coping on the Child Family Adjustment Scale (CFAS, measure created for this study) compared to both the divorce controls and intact comparison children. Similarly, the intervention children reported significantly less anxiety (p<.01) on the STAIC and parents described them as better adjusted (p<.001) compared to children in the other two groups. In addition, intervention children reported significantly more positive divorce-related attitudes (p<.003) on the Childrens Attitudes and Self Perceptions (CASP; Pedro-Carroll & Cowen, 1985) compared to the divorce controls.
Strengths & Limitations:
The Children of Divorce Intervention Program is designed to prevent potential mental health complications (i.e. anxiety, behavior problems) in children that may result from parental divorce. The program focuses solely on the child, and is designed to create a support network that facilitates discussion of divorce-related feelings and attitudes and reduces the likelihood that the child will engage in self-blame for the events taking place. The program attempts to build the childs social problem solving and anger management skills. Out of three studies that evaluated the program only one utilized a randomized trial (Pedro-Carroll & Cowen, 1985) and the others relied on a quasi-experimental designs; the latter design limits the strength of the conclusions that can be drawn from the results. In addition, there was some variation across studies in the degree to which the samples were adequately matched or differences found between groups were managed statistically. However, the fact that CODIP has been evaluated multiple times and that the findings are generally consistent across evaluations is promising. Most of the studies found improvements in childrens self-reported anxiety, parent-reported adjustment, and teacher-rated competence. Some evaluations also found teacher ratings of problem behavior improved for children in the program. One caveat is that the follow-up period was not extended in any of the evaluations so it is impossible to determine whether treatment gains were maintained over the long-term. Bias from respondents was also likely to have inflated treatment effects because individuals were aware of status of children.
The authors provided information in each study regarding their attempts to maintain treatment fidelity. Each of the three studies evaluating CODIP included group leader training and on-going supervision. Training took place one month prior to the beginning of the program and group discussions, and supervision occurred weekly during the intervention period (Pedro-Carroll & Cowen, 1985; Pedro-Carroll et al., 1992; Pedro-Carroll et al., 1986).