Peer-reviewed article
'Pilot RCT of a new treatment for child conduct problems that have not responded to evidence-based parent training'.
Sharp H, Roff H, Wright N, Pickles A, Hill J ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This pilot trial tested a new therapy called RICAP for children aged 4-10 with conduct problems that did not improve after parent training. The study involved 105 children referred to UK mental health services who first received parent training, then those still showing problems were randomly assigned to either RICAP or standard care. RICAP showed better results according to parents but standard care showed better results according to teachers, suggesting outcomes depend on who is reporting and the treatment setting.
Key points
- High retention and acceptability: 102 of 105 children completed initial parent training, and most RICAP participants attended 11 or more of 14 sessions
- By parent report, RICAP was superior to standard care on both externalising problems (d=0.32) and internalising problems (d=0.42)
- By teacher report, standard care was superior to RICAP on SDQ total problems (d=0.32) and reactive aggression (d=0.27)
- The study demonstrates feasibility of testing new interventions specifically for children who do not respond to initial evidence-based parent training
- Outcomes varied significantly depending on whether parents or teachers reported on child behavior
Limitations
This is a pilot study with a small sample, and the contradictory findings between parent and teacher reports make it unclear whether RICAP is truly effective. The study cannot determine which reporter perspective is more accurate or why treatment effects differ so markedly by context.
Abstract
Background Children with conduct problems are at high risk of persisting mental health problems, making them a priority for early intervention. Group-based parent-training is effective but with a substantial failure rate. Based on evidence on the value of involving children, we developed Reflective Interpersonal Therapy for Children and Parents, (RICAP). We report feasibility and outcomes from the first pilot trial of an intervention for children with conduct problems persisting after parent training. In contrast to most studies, we used both parent and teacher report. Methods The sample comprised 105 children and their parents aged 4-10 years inclusive referred to UK Child and Adolescent Mental Health Services (CAMHS) with conduct problems. All were offered the Incredible Years (IY) parent training intervention, and parents provided pre- and post-treatment measures (including CBCL, SDQ). Children still above clinical threshold after IY were randomized either to RICAP or to usual CAMHS treatment (CTAU) with follow up 8 months later. Only those randomized to CTAU could receive school-based interventions. Trial Registration Number: ISRCTN25252940. Results Feasibility was supported by high retention through the initial IY (102/105) and subsequent RCT phases of the study (58/70 eligible for randomization). The majority of those randomized to RICAP attended for 11/14 or more sessions, reflecting its high acceptability to both children and parents. By parent report RICAP was superior to CTAU on CBCL externalising (d = 0.32) and internalising (d = 0.42) problems, while by teacher report CTAU was superior on SDQ total problems (d = 0.32) and reactive aggression (d = 0.27). Conclusions We provide first evidence of the feasibility of a design in which non-responders to parent training are randomized to novel intervention or control conditions. Outcomes were different for parent and teacher reports, highlighting for future randomized controlled trials the need to attend to possible reporter and treatment context variations.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Reflective Interpersonal Therapy for Children and Parents (RICAP), a new treatment involving both children and parents
- Population
- 105 children aged 4-10 years referred to UK Child and Adolescent Mental Health Services; 70 were eligible for randomization after initial parent training (Incredible Years)
Key finding
By parent report, RICAP superior to CTAU on CBCL externalising problems (d=0.32) and internalising problems (d=0.42)
H et al. · Europe PMC · 28 Jul 2026