***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A growing number of children in the UnitedStates are being placed into foster care . Past studies indicate that effective case manager interventions havehelped foster families with a variety of different problems . This study enrolled a r and omlyselected sample of 130 children under age four who hadbeen newly placed into foster care . The purpose of this study was to identify the services needed by foster care families and determine which servicesrequire the most case manager effort . Consistent withother research , many foster care children in this study exhibited developmental , medical and psychosocial concerns . Nevertheless , we found that it wasservices aim ed at the foster care parents , rather thanthe foster care children , that required the mostlabor-intensive case management services The purpose of this study was to evaluate the effectiveness of a 2-component intervention for biological and foster parent ( pairs )  to improve parenting practice s , co-parenting , and child externalizing problems .  Participants were biological and foster parents ( N=128 ) of primarily neglected children ( ages 3 to 10 years ) placed in regular foster homes . Biological and foster parents were r and omly assigned in pairs to the intervention ( n=80 ) or a usual care ( n=48 ) condition . Intervention families received a 12-week parenting course ( Incredible Years ) and a newly developed co-parenting component . Key findings included significant gains in positive parenting and collaborative co-parenting for both biological and foster parents at the end of the intervention . At follow-up , intervention parents sustained greater improvement in positive parenting , showed gains in clear expectations , and reported a trend for fewer child externalizing problems . Findings supported the feasibility of offering joint parenting training to meet the needs of participating families and demonstrated that the co-parenting construct applied to families in the foster care system was amenable to intervention The lack of prepared and available foster parents for children with prenatal substance effects is of increasing concern to the child welfare field . The research study reported here evaluated a multimodal inservice training program design ed to enhance the competency of foster parents caring for infants with prenatal substance effects , and to promote an intent to foster such infants . Findings suggest that future foster parent training efforts in this area should focus on knowledge and skill attainment Department of Parent and Child NursingUniversity of WashingtonClinic mothers of 35 conduct-disordered children were r and omly assigned to awaiting list  control group  , 9 weeks of individual therapy , or 9 weeks of therapist-led group therapy based on a st and ardized videotape modeling program .  Mothers and their children were assessed at baseline , immediately after treatment , and 1year later by home visits , twice-per-week telephone reports , and question naires . One month after treatment , both groups of treated mothers showed significantattitudinal and behavioral improvements compared with untreated controls . Ad-ditionally , the children in the two treatment groups showed reductions in childnoncompliance compared with control children . At the 1-year follow-up , not onlywere most of the changes in mothers ' behaviors maintained , but both treatmentgroups of children continued to show significant reductions in noncompliant and deviant behaviors . There were no significant differences on any of the attitudinalor behavioral measures between individual and videotape modeling group discussion therapies at the immediate or 1-year follow-up . Total therapist time was approx-imately 251 hr for the entire individual group and 48 hr for the entire videotape discussion group . Although both treatments seem to offer equivalent and sustainedimprovements for parents and conduct-disordered children , the therapeutic efficiencyof the videotape modeling group format is more cost-effective . In response to the large numbers of childrenwith conduct disorders and the shortage ofprofessional personnel , there has been an in-creasing emphasis on training parents as ther-apists for their own children . Several excellent review s ( Berkowitz & Graziano , 1972 ; Gra-ziano , 1977 ; Johnson KMorel and , Schwebel , Beck , & Wells , 1982 ; Pawlicki AIMS To evaluate the impact of training foster carers  on  children 's emotional and behavioural functioning .  METHODS In a r and omised controlled trial in 17 Scottish local council areas , with immediate and nine month follow up , 182 children and their foster families were r and omly allocated to either st and ard services alone or st and ard services plus extra training for foster carers on communication and attachment . Main outcome measures were child psychopathology , attachment disorder , self esteem , and cost of foster care . RESULTS Over 60 % of children had measurable psychopathology at baseline . The training was perceived as beneficial by participants . Scores for parent reported psychopathology and attachment disorders decreased by around 5 % , self esteem increased by 2 % , and costs by 22 % in the intervention group . Results were non-significant . CONCLUSIONS Despite being well received by foster carers , the training was not sufficient to make a useful impact on the high level of psychopathology . This group may warrant more intensive interventions This study was undertaken to assess the effects of holding therapy on children who have a history of aggressive and delinquent behaviors . The study design was a prospect i ve , pre-post , quasi-experimental controlled study . The subjects were recruited through the Attachment Center at Evergreen , Colorado . Eligible subjects were adopted children between the ages of 5–14 years , living in the present adopted home for at least one year . All children had a history of aggressive and delinquent behaviors , which prompted the contact with Evergreen . Findings result ed in significant decrease in the outcome variable for the treatment group within this study OBJECTIVE To determine the effectiveness of an intervention design ed to improve outcomes for infants and toddlers in foster care . METHOD Records were review ed for all children who were adjudicated as in need of care in a specific parish in Louisiana between 1991 and 1998 . This period included 4 years before and 4 years after a comprehensive intervention was implemented . Children adjudicated between 1991 and 1994 were the comparison group , and those adjudicated between 1995 and 1998 were the intervention group . RESULTS After the intervention , more children were freed for adoption and fewer children were returned to their birth families than before the intervention . There was no difference in length of time in care before and after the intervention . With regard to the same child returning in a subsequent incident of maltreatment , relative risk reduction for the intervention group ranged from 53 % to 68 % . With regard to the same mother maltreating another child subsequently , relative risk reduction for the intervention group ranged from 63 % to 75 % . CONCLUSIONS A comprehensive preventive intervention for maltreated infants and toddlers in foster care substantially reduced rates of recidivism but had no effect on length of time in care Families of 97 children with early-onset conduct problems , 4 to 8 years old , were r and omly assigned to 1 of 4 conditions : a parent training treatment group ( PT ) , a child training group ( CT ) , a combined child and parent training group ( CT + PT ) , or a waiting-list control group ( CON ) . Posttreatment assessment s indicated that all 3 treatment conditions had result ed in significant improvements in comparison with controls . Comparisons of the 3 treatment conditions indicated that CT and CT + PT children showed significant improvements in problem solving as well as conflict management skills , as measured by observations of their interactions with a best friend ; differences among treatment conditions on these measures consistently favored the CT condition over the PT condition . As for parent and child behavior at home , PT and CT + PT parents and children had significantly more positive interactions , compared with CT parents and children . One-year follow-up assessment s indicated that all the significant changes noted immediately posttreatment had been maintained over time . Moreover , child conduct problems at home had significantly lessened over time . Analyses of the clinical significance of the results suggested that the combined CT + PT condition produced the most significant improvements in child behavior at 1-year follow-up Abstract Objective : To see whether a behaviourally based group parenting programme , delivered in regular clinical practice , is an effective treatment for  antisocial behaviour in children . Design : Controlled trial with permuted block design with allocation by date of referral . Setting : Four local child and adolescent mental health services . Participants : 141 children aged 3 - 8 years referred with antisocial behaviour and allocated to  parenting groups  ( 90 ) or waiting list control  ( 51 ) . Intervention : Webster-Stratton basic videotape programme administered to parents of six to eight children over 13 - 16 weeks . This programme emphasises engagement with parental emotions , rehearsal of behavioural strategies , and parental underst and ing of its scientific rationale . Main outcome measures :  Semistructured parent interview and question naires about antisocial behaviour in children administered 5 - 7 months after entering trial ; direct observation of parent-child interaction . Results : Referred children were highly antisocial  ( above the 97th centile on interview measure ) . Children in the intervention group showed a large reduction in antisocial behaviour ; those in the waiting list group did not change ( effect size between groups 1.06 SD ( 95 % confidence interval 0.71 to 1.41 ) , P<0.001 ) . Parents in the intervention group increased the proportion of praise to ineffective comm and s they gave their children threefold , while control parents reduced it by a third ( effect size between groups 0.76 ( 0.16 to 1.36 ) , P=0.018 ) . If the 31 children lost to follow up were included in an intention to treat analysis the effect size on antisocial behaviour was reduced by 16 % . Conclusions : Parenting groups effectively reduce serious antisocial behaviour in children in real life conditions . Follow up is needed to see if the children 's poor prognosis is improved and criminality prevented . What is already known on this topic Children who persistently display a high level of antisocial behaviour are at high risk of social rejection , juvenile delinquency , and long term unemployment ; the cost to society is high While some behaviourally based parenting programmes have been shown to be effective in university centre trials with volunteers or specially selected cases , most trials of psychological treatments for children in real life setting s have shown no effect What this study adds An evidence based intervention is available for use in regular clinical practice that effectively reduces antisocial behaviour in referred children The intervention works well with children at risk of criminality from a combination of highly antisocial behaviour , multiple psychopathology , and social This article describes group parent training procedures for a sample of 42 foster mothers . Half of the foster mothers were trained in behavioral child-rearing skills  , and the other half received reflective group counseling for 8 weeks . Comparison of the two modes of training showed that reflectively counseled mothers improved primarily in parent attitudes , whereas behaviorally trained mothers improved primarily in actual use of appropriate behavioral skills , reporting reductions in problematic child behavior and improvements in overall family functioning . The future use of a combination approach is addressed , as are suggestions regarding how to motivate foster parents and improve their attendance rates . Throughout the 1970s the use of parent counseling and training has grown as a means of employing parents as therapists for their children 's problem behaviors . Tavormina ( 1974 ) discussed two major topics of parent counseling : ( a ) reflective counseling , which emphasizes parental awareness , underst and ing , and acceptance of the child 's feelings , and ( b ) behavioral counseling , which emphasizes actual observable behavior and the environmental variables that maintain certain behavior patterns . In a comparison of the relative effectiveness of the two procedures ( Tavormina , 1975 ) , both had beneficial effects relative to the notreatment control condition , but the behavioral method result ed in a significantly greater magnitude of improvement across attitude and behavior change dimensions . Tavormina 's ( 1975 ) study trained biological mothers of retarded children , and the present study represents an extension of that study to foster mothers , who differ from other parents along several dimensions . First , these parents are charged with the duty of managing children who are wards of the state , yet they have consistently been implicated as being neither economically nor therapeutically prepared to manage the children entrusted to their care ( Levitt , 1973 ) . Second , foster children as 
    Output:
    
MAIN RESULTS Training interventions evaluated to date appear to have very little effect on outcomes relating to looked-after children , assessed in relation to psychological functioning , extent of behavioural problems and interpersonal functioning .
Results relating to foster carer(s ) outcomes also show no evidence of effectiveness in measures of behavioural management skills , attitudes and psychological functioning .
Analysis pertaining to fostering agency outcomes did not show any significant results .
There is currently little evidence about the efficacy of CBT-based training intervention for foster carers .