A follow-up study on the aggression replacement training (ART) intervention

Abstract

This study is a follow-up of the intervention Aggression Replacement Training (ART) in Iceland. The ART treatment was introduced in Iceland in 2007 as an experimental project in an elementary school in the southern part of Iceland. Subsequently it has grown as a project, training teachers all over the country, although the base continues to be located in Selfoss in the south of Iceland. The current study was originally planned as a final component of a two-section evaluation of the ART intervention, with the first segment consisting of measures at the beginning and conclusion of the intervention, with the current study following up on the participants three years later. The overall aim was to evaluate both the effect of the ART intervention as a means to reduce internal and external problems experienced by the children as well as the durability of the effects. The results of the first two sections were reported in an earlier paper, with the current paper completing the picture by adding the three-year follow up. The evaluation of ART for the current study was based on answers from elementary school teachers who had thought 12 children who participated in ART-treatment among their families in 2017. The children and their teachers also participated in the earlier sections of the study. In order to assess the children’s symptoms, the Icelandic translation and standardization of the ASEBA assessment tool was used at three time points: 1) two weeks before the ART-treatment started, 2) about two weeks after ART-treatment had taken place and 3) three years after the ART-treatment. The records were used to assess both internal and external problems among the children. Only the teacher rating form was used in the follow- up study, whereas the children’s self-report and parents’ forms were also included in the earlier evaluations. In the first part of the study both internal
and external symptoms decreased significantly from pre-intervention to post intervention measures. Similarly, in the first section of the research-, both internal and external problems decreased significantly from the first to the second evaluation. When the evaluations of children were compared, they showed fewer behavior problems, less distress and better social skills following ART treatment. However, none of those effects lasted in the follow up, three years later for the group as a whole. The results of the evaluations were divided into four groups; 1) permanently reduced symptoms (three children), 2) reduced symptoms that recurred (four children), 3) little change in symptoms (three children) and 4) irregular changes in symptoms (two children). The results indicate that a better follow-up treatment is needed in order to maintain the positive changes that occurred during the intervention. In addition, a regular evaluation would be beneficial in order to monitor the children before and after treatment and to determine whether they need a follow-up treatment and for how long. In addition to reporting the results of the follow-up study, the authors also discuss practical problems encountered when evaluating intervention programs in a small society with about 170 schools at the grade school level and 350 at the pre-school level.
The current project is one of only a handful of empirical evaluations of interventions for psychological or social problems that have been carried out in Iceland. The authors suggest that the municipalities, primary providers of instructional, psychological, and social interventions, establish a common evaluation and data collection scheme and add an evaluation dimension to all contracts for such services. A joint effort by all municipalities can reveal which intervention programs are best suited for various purposes and can also
allow for joint evaluation of new and promising intervention programs.