Abstract
Background
Little evidence exists regarding outcomes of therapeutic interventions for maltreated children who are removed from their birth families and then adopted. This study follows on from a previous evaluation of the Neuro-Physiological Psychotherapy (NPP) model, which found significant, positive and sustained post-treatment change.
Objective
To compare the outcomes for the NPP intervention group to those of a control group.
Participants and setting
Participants were families who received the NPP intervention and families who, following assessment, did not receive the NPP intervention as recommended.
Methods
Groups were matched in terms of demographics and presentation at assessment. A comparison of outcomes took place using ANCOVA.
Results
Significant differences were found between group measures of Behavioral Regulation Index (moderate effect size, Cohen’s d = .435; F(1, 1505) = 14.476, p = .000) and Global Executive Functioning (BRIEF) (small effect size, Cohen’s d = .147; F(1, 3506) = 7.771, p = .008); mental health difficulties common in maltreated children (ACC/ACA) (small effect size, Cohen’s D = .212; F(1, 1100) = 6.197, p = .020) and externalizing behavior (CBCL) (small effect size, Cohen’s D = .025; F(1, 686) = 5.420, p = .025). A comparison of parent responses on quantitative aspects of a structured interview using chi-square analysis revealed significant differences between the groups on relationship quality (x2 (2, N = 53) = 10.453, p = .005 with a medium effect size, Cramer’s V = .444), disruption (x2 (1, N = 54) = 4.998, p = .025. The effect size was medium with Cramer’s V = .304), parental separation rates (x2 (1, N = 45) = 9.474, p = .002. The effect size was moderate with Cramer’s V = .459) and several indicators for longer-term social inclusion. The results are discussed in the light of the model’s neurodevelopmental and sequential approach, which focuses on sensory integration, affect regulation and therapeutic life story work alongside parent and school support.
Conclusions
Implications regarding current treatment guidelines for this population are discussed; and a call is made for interventions which actively consider and address the neurodevelopmental impact of maltreatment.