[Bibliotherapy as a self-help program for parents of children with externalizing problem behavior].

OBJECTIVES

Externalizing problem behaviour is one of the most frequent and most stable behavioural disorders of childhood and adolescence. The development of applicable alternatives to expensive and restrictedly available treatments becomes increasingly necessary. This pilot study tested bibliotherapy in the form of a manual-assisted self-help programme under minimum contact conditions for parents of children with externalizing problem behaviour.

METHOD: A total of 21 children, aged 6 to 15 years and diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) and/or an Oppositional Defiant Disorder, were recruited from an outpatient population. The bibliotherapy lasted 10 weeks and consisted of working through a self-help book for parents (Wackelpeter und Trotzkopf). Initial clinical interviews and pre- and post-treatment evaluations were included, as well as short weekly telephone contacts (approx. 20 min. per contact) with the parents.

RESULTS

The children's externalizing behaviour was significantly reduced during the intervention. The parenting skills were strengthened. The satisfaction of the parents with the program was high. Fewer than 20% of the parents indicated a need for an additional intensive behavioural outpatient treatment at the end of the intervention.

CONCLUSIONS

Bibliotherapy may be an applicable and effective treatment alternative for children with disruptive behaviour disorders, at least in families with the resources necessary for this kind of intervention. The results have to be replicated within randomized control group trials.