A time-limited group intervention to promote social competance in children referred to a child guidance clinic
Poor peer relationships and low self-esteem are common attributes of children referred to a Child Guidance Clinic. Peer relationships and self-esteem exert a synergistic effect on one another, both acting as bidirectional sources of stress or support ('protective factors' or 'risk factors'). While positive peer relationships are important for healthy social, cognitive and psychological development, poor relationships in childhood predate adult adjustment problems. In particular, peer relationships and the social bonds that maintain self-esteem play a role in the development, symptomatology, course and outcome of childhood depression. Thus, intervening on the level of peer relationships and self-esteem may be an important aspect of a comprehensive treatment programme for children which considers the impact of the broader social environment on a child's psychological development. Literature suggests that cognitively-based 'social-skills training' or 'social-competence promotion' programmes can significantly improve sociometric status and self-esteem, and that groups are an appropriate modality for working with children. This study described and evaluated an 8 session group intervention which targeted interpersonal relationships through: (i) building self-esteem; (ii) teaching social skills; and (iii) developing interpersonal cognitive problem-solving skills. 2 girls and 5 boys aged 8-9 years with poor peer relationships participated in the intervention. Activities designed to teach circumscribed aspects of relevant social skills formed the basis of the programme, which was applied flexibly in order to meet the changing needs of the group. In order to evaluate outcome of the intervention, qualitative and quantitative data were collected from various sources and used to support clinical assessments. Individual benefits were assessed by evaluating the response of one child against the background of the group as a whole. The measures used to evaluate outcome were: (i) a 'Party List' - a sociometric technique for collecting data about friendship choices; (ii) the Piers-Harris Children's Self Concept Scale; (iii) standard semi-structured interviews with class teachers to obtain descriptions of social and academic adjustment and peer relationships; (iv) ratings of videotaped sequences of behaviour designed to assess changes in interactive behaviour; (v) a clinical assessment of group process (which provided a qualitative assessment of individual and group functioning, and an ongoing evaluation of group process). In general, statistical measures indicated mildly positive results of variable significance. Qualitative results suggested that the intervention effected variable improvements in self-concept and general adjustment of all the children, and improvement in the peer relationships of the target child. Teachers and parents expressed positive attitudes to the intervention, and clinically trained research assistants noted distinct positive changes in the behaviour of the target child. The accuracy and conclusiveness of these results was tempered by various problems which are discussed. It could not be concluded that changes noted were due to the intervention alone, or were more effective than any other intervention or than no intervention at all. Although results were modest, the improvements made by one child were judged to be clinically significant. This type of intervention offered some advantages in that it: (i) was relatively cost effective; (ii) lends itself to development for use in the community by non-psychologists; and (iii) minimizes some of the problems inherent in long-term individual therapy or pharmacotherapy with a child. It was proposed that this form of intervention might be particularly useful as part of multimodal intervention programme, and may have implications as a preventative intervention technique.
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