Collaborative & Proactive Solutions (CPS)

Scientific Rating:
2

(provisional rating)

Supported by Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium

(provisional rating)

See descriptions of 3 levels

Provisional Rating

Collaborative & Proactive Solutions (CPS) currently has a provisional rating for the 60 days between: May 5, 2017 and July 4, 2017. If you would like to respond to the Scientific Rating, please submit feedback via the Contact Us page.

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Collaborative & Proactive Solutions (CPS) has been rated by the CEBC in the area of: Disruptive Behavior Treatment (Child & Adolescent).

Target Population: Children ages 4-14 who experience oppositional episodes and their parents

For children/adolescents ages: 4 – 14

For parents/caregivers of children ages: 4 – 14

Brief Description

CPS is a treatment model that is designed to help parents/caregivers and children learn to collaboratively and proactively solve the problems that contribute to the children’s challenging behaviors, with the goal of improving family communication, cohesion, and relationships. It is made up of four modules that teaches parents: (a) to identify lagging skills and unsolved problems that contribute to oppositional episodes; (b) to prioritize which unsolved problems to focus on first; (c) about the Plans framework—the three potential responses to solving problems: Plan A (solving a problem unilaterally, by imposing the adult will), Plan B (solving a problem collaboratively and proactively), and Plan C (setting aside the problem for now); and (d) how to implement Plan B with their child by gathering information from the child to get a clear understanding of their concern or perspective, defining the adult concern on the same unsolved problem, and finally having the child and adult brainstorm solutions to arrive at a plan of action that is both realistic and mutually satisfactory. The clinician actively guides the initial problem-solving process, however, the goal of treatment is to help the child and parents become independent in solving problems together. In general, parent(s) and child are in attendance at all of the sessions, although there are times when a clinician may feel that it would be beneficial to discuss certain issues with the child or parent(s) individually.

Program Goals:

The goal of Collaborative & Proactive Solutions (CPS) is:

  • Identify and solve unsolved problems that contribute to oppositional episodes

Essential Components

The essential components of Collaborative & Proactive Solutions (CPS) include:

  • How to identify lagging skills and unsolved problems that contribute to oppositional episodes
  • How to prioritize which unsolved problems to focus on first
  • Understanding the Plans frameworks—the three potential responses to solving problems:
    • Plan A (solving a problem unilaterally, by imposing the adult will)
    • Plan B (solving a problem collaboratively and proactively)
    • Plan C (setting aside the problem for now)
  • How to use Plan B Including:
    • Gathering information about and achieving a clear understanding of the child’s concern or perspective on the unsolved problem
    • Sharing the concern of the second party (often the adult)
    • Generating solutions that are realistic (meaning both parties can do what they are agreeing to) and mutually satisfactory (meaning the solution truly addresses the concerns of both parties)
  • Trouble shooting interfering factors (factors interfering with caregivers’ capacity to implement Plan B such as disorganization, time, family dysfunction and dynamics, marital issues, and so forth)
  • Helping caregivers prepare for the sustained use of Plan B

Child/Adolescent Services

Collaborative & Proactive Solutions (CPS) directly provides services to children/adolescents and addresses the following:

  • The problems that are contributing to oppositional behaviors

Parent/Caregiver Services

Collaborative & Proactive Solutions (CPS) directly provides services to parents/caregivers and addresses the following:

  • Parents or caregivers of children who have oppositional episodes and may have issues that interfere with effective parenting such as disorganization, lack of time, family dysfuntion and dynamics, or marital issues
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Caregivers in other settings may be involved in the problem-solving process if there are oppositional episodes in those settings.

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Community Agency
  • Foster/Kinship Care
  • Hospital
  • Outpatient Clinic
  • Residential Care Facility
  • School
  • Juvenile detention/justice facility

Homework

Collaborative & Proactive Solutions (CPS) includes a homework component:

Families are encouraged to practice solving problems collaboratively independently at home between sessions.

Languages

Collaborative & Proactive Solutions (CPS) has materials available in languages other than English:

Bulgarian, Chinese, Danish, Dutch, Finnish, French, German, Hebrew, Italian, Japanese, Korean, Norwegian, Polish, Romanian, Russian, Spanish, Swedish, Turkish, Vietnamese

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Meeting space to permit family therapy

Minimum Provider Qualifications

There is no minimum educational requirement to become a provider. For a clinician or educator to become certified in the CPS model, they must participate in a 24-week CPS training program.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

Much training is provided by teleconference, but also through webinars and onsite training.

Number of days/hours:

Variable, depending on the type of training

Implementation Information

Since Collaborative & Proactive Solutions (CPS) is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

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Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Collaborative & Proactive Solutions (CPS).

Formal Support for Implementation

There is formal support available for implementation of Collaborative & Proactive Solutions (CPS) as listed below:

There are several dozen certified trainers who support implementation of the model in schools and facilities throughout the world. These trainers provide initial training as well as ongoing consultation.

Fidelity Measures

There are no fidelity measures for Collaborative & Proactive Solutions (CPS).

Implementation Guides or Manuals

There are implementation guides or manuals for Collaborative & Proactive Solutions (CPS) as listed below:

The CPS model is described in the following publications:

  • Greene, R. W. (2014). The explosive child: A new approach for understanding and parenting easily frustrated, chronically inflexible children. HarperCollins World. New York, NY.
  • Greene, R. W. (2016). Lost and found. Jossey-Bass. San Francisco, CA.
  • Greene, R.W. (2014). Lost at school: Why our kids with behavioral challenges are falling through the cracks and how we can help them. Scribner, New York, NY.

Videos and other supporting materials for implementing CPS are available on the Lives in the Balance website:http://www.livesinthebalance.org/

Research on How to Implement the Program

Research has been conducted on how to implement Collaborative & Proactive Solutions (CPS) as listed below:

  • Greene, R. W., Ablon, J. S., Monuteaux, M., Goring, J., Henin, A., Raezer, L., … Rabbitt, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated youth with oppositional defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72, 1157-1164.
  • Greene, R. W., Ablon, S. A., & Martin, A. (2006). Innovations: Child psychiatry: Use of Collaborative Problem Solving* to reduce seclusion and restraint in child and adolescent inpatient units. Psychiatric Services, 57(5), 610-616.
  • Martin, A., Krieg, H., Esposito, F., Stubbe, D., & Cardona, L. (2008). Reduction of restraint and seclusion through Collaborative Problem Solving: A five-year, prospective inpatient study. Psychiatric Services, 59(12), 1406-1412.
  • Ollendick, T. H., Greene, R. W., Fraire, M. G., Austin, K. E., Halldorsdottir, T., Allen, K. B., … Wolff, J. C. (2016). Parent Management Training (PMT) and Collaborative & Proactive Solutions: A randomized control trial for oppositional youth. Journal of Clinical Child and Adolescent Psychology 45(5): 591-604

Relevant Published, Peer-Reviewed Research

This program is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The program must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. The article(s) below that reports outcomes from an RCT showing a sustained effect of at least 6 months has an asterisk (*) at the beginning of its entry. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Greene, R. W., Ablon, J. S., Monuteaux, M., Goring, J., Henin, A., Raezer, L., … & Rabbitt, S. (2004). Effectiveness of Collaborative Problem Solving in affectively dysregulated youth with oppositional defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72, 1157-1164.

Type of Study: Randomized controlled trial
Number of Participants: 47

Population:

  • Age — Children: 4-12 years, Adults: Not specified
  • Race/Ethnicity — Not specified
  • Gender — Children: 32 Male and 15 Female, Adults: Not specified
  • Status — Participants were parents and their children with oppositional defiant disorder (ODD).

Location/Institution: Not specified

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined the efficacy of Collaborative Problem Solving (CPS) [now called Collaborative & Proactive Solutions (CPS)] in affectively dysregulated children with oppositional defiant disorder (ODD). Participants were randomized to CPS or parent training (PT). Measures utilized include the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Epidemiologic version (K-SADS-E), the Wechsler Intelligence Scale for Children-Revised, the Parent-Child Relationship Inventory (PCRI), the Parenting Stress Index (PSI), the Oppositional Defiant Disorder Rating Scale (ODDRS), and the Clinical Global Impression–Improvement (CGI-I). Results indicated CPS produced significant improvements across multiple domains of functioning at posttreatment and at 4-month follow-up. Limitations included small sample size and length of follow-up.

Length of postintervention follow-up: 4 months.

Greene, R. W., Ablon, J. S., & Martin, A. (2006). Use of Collaborative Problem Solving to reduce seclusion and restraint in child and adolescent inpatient units. Psychiatric Services, 57(5): 610-612.

Type of Study: One group pretest-posttest study
Number of Participants: 134

Population:

  • Age — Children: 3-14 years, Adults: Not specified
  • Race/Ethnicity — Not specified
  • Gender — Children: 74 Male and 26 Female, Adults: 24 Female and 10 Male
  • Status — Participants were children and adolescents with trauma histories and severe oppositional defiance and aggressiveness who were admitted and treated by staff at an inpatient treatment facility.

Location/Institution: Massachusetts

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of Collaborative Problem Solving (CPS) [now called Collaborative & Proactive Solutions (CPS)] on staff restraint use in a sample of children and adolescents in an inpatient treatment program for severe oppositional defiance and aggressiveness. The intervention provided biweekly staff training sessions that lasted one year on restraint training using the CPS model. Surveys administered to staff during at a 15-month post-intervention follow-up showed a significant decrease in rates of restraint and seclusion and a decrease in the length of restraint procedures and injuries. Limitations include lack of randomization and lack of a control or comparison group.

Length of postintervention follow-up: 15 months.

Martin, A., Krieg, H., Esposito, F., Stubbe, D., & Cardona, L. (2008). Reduction of restraint and seclusion through Collaborative Problem Solving: A five-year, prospective inpatient study. Psychiatric Services, 59(12), 1406-1412.

Type of Study: One-group pretest-posttest study
Number of Participants: 755

Population:

  • Age — Children: 10-11 years; Adults: Not specified
  • Race/Ethnicity — Children: 52% White, 25% Black, and 23% Hispanic; Adults: Not specified
  • Gender — Children: 63% Male and 37% Female; Adults: Not specified
  • Status — Participants were aggressive children and adolescents in a psychiatric inpatient hospital.

Location/Institution: Yale–New Haven Children’s Hospital

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined usage patterns of restraint and seclusion before and after the implementation of Collaborative Problem Solving (CPS) [now called Collaborative & Proactive Solutions (CPS)] for working with aggressive children and adolescents. Measures utilized include demographic and clinical information from electronic medical records and psychiatric forms. Results indicated after implementation of the CPS model there was a reduction in the use of restraints (from 263 events to seven events per year) and seclusion (from 432 to 133 events per year). During the early phases of implementation there was a transient increase in staff injuries through patient assaults. Limitations included results do not permit a clear delineation of which exact components were active in reducing use of restraint and seclusion due to several milieu changes were instituted at the same time as part of the CPS model of care, did not include objective measures of adherence to the CPS model, and no systematic data on child injuries.

Length of postintervention follow-up: 1.5 years.

*Ollendick, T. H., Greene, R. W., Austin, K. E., Fraire, M. G., Halldorsdottir, T., Allen, K. B., ... Noguchi, R. J. (2015). Parent Management Training and Collaborative & Proactive Solutions: A randomized control trial for oppositional youth. Journal of Clinical Child & Adolescent Psychology, 45(5): 591-604doi:10.1080/15374416.2015.1004681.

Type of Study: Randomized controlled trial
Number of Participants: 134

Population:

  • Age — Children: 7-14 years, Adults: Not specified
  • Race/Ethnicity — Children: 83.6% White, Adults: Not specified
  • Gender — Children: 61.9% Male and 38.1% Female, Adults: Not specified
  • Status — Participants were families with adolescents with oppositional defiant disorder (ODD).

Location/Institution: Rural southwest Virginia

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined the efficacy of Collaborative & Proactive Solutions (CPS) in treating oppositional defiant disorder (ODD) in youth. Participants were randomized to CPS, Parent Management Training (PMT), or a 6-week waitlist control (WLC) group. Following the waiting period, those youth and families in the WLC group who continued to meet criteria for ODD and still desired treatment were randomly reassigned to one of the two treatment groups. Measures utilized include the Peabody Picture Vocabulary Test, 4th Edition, the Expressive Vocabulary Test, 2nd Edition, the Anxiety Disorders Interview Schedule for DSM–IV, child and parent versions (ADIS-C/P), the Clinical Global Impression–Severity (CGI-S), the Disruptive Behavior Disorders Rating Scale (DBDRS), the Behavior Assessment System for Children–Second Edition (BASC), the Parent Consumer Satisfaction Questionnaire, and the Clinical Global Impression–Improvement (CGI-I). Results indicated that both treatment conditions were superior to the WLC condition but did not differ from one another in either responder or remitter analyses. Approximately 50% of youth in both active treatments were diagnosis free and were judged to be much or very much improved at posttreatment, compared to 0% in the waitlist condition. Younger age and presence of an anxiety disorder predicted better treatment outcomes for both PMT and CPS. Treatment gains were maintained at 6-month follow-up. Limitations included high attrition rate, generalizability due to sample of largely middle-class Caucasian families, and decision was made to drop the WLC condition because none of the 11 families improved during the wait period.

Length of postintervention follow-up: 6 months.

References

Greene, R. W. (2014). The explosive child: A new approach for understanding and parenting easily frustrated, chronically inflexible children. HarperCollins World. New York, NY.

Greene, R. W. (2016). Lost and found. Jossey-Bass. San Francisco, CA.

Greene, R.W. (2014). Lost at school: Why our kids with behavioral challenges are falling through the cracks and how we can help them. Scribner, New York, NY.

Contact Information

Name: Ross W. Greene, PhD
Agency/Affiliation: Lives in the Balance and Virginia Tech
Department: Department of Psychology
Website: www.livesinthebalance.org
Email:
Phone: (207) 518-9135

Date Research Evidence Last Reviewed by CEBC: September 2016

Date Program Content Last Reviewed by Program Staff: May 2017

Date Program Originally Loaded onto CEBC: May 2017