(From the ISHN Member information service) Recently we have been discussing the value and limits of Random Control Trials (RCT) and subsequent systematic reviews based on those trials. Although it does not discuss school-related programs directly, an article the February 2015 issue of Children and Youth Services Review continues this discussion, noting the need to control or at least accurately describe the control groups used in comparison with the intervention being tested. The authors ask if "Does allocation to a control condition in a Randomized Controlled Trial affect the routine care foster parents receive? And, of course, the answer is yes. "Strengthening Foster parents in Parenting’ (SFP) is a support program for foster parents who care for foster children with externalizing problem behavior. Its effectiveness was examined with a Randomized Controlled Trial (RCT). In this paper, we examine the treatment as usual (TAU) that was offered in the control condition of this RCT. For this purpose, the TAU from the SFP control group was compared with TAU provided to a similar group of foster parents outside any RCT. Our results show that TAU is diverse and varies widely. Furthermore, being part of the control condition was positively associated with both the counseling frequency from the foster care services and with external help-seeking behavior (finding and using additional support). In order to prevent condition contamination in future trials, TAU should be clearly described and standardized, and treatment fidelity should be carefully monitored." We suspect that this natural inclination to improve performance while being part of a research study will also affect school-based studies. Further, as the authors note (and as we have commented before, the Treatment As Usual" condition, even as is, may actually be quite close to the intervention being tested. Read more>>
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