This thesis presents a program of research evaluating the implementation of a primary care intervention program for disruptive child behaviour, and the process of dissemination of the intervention to primary care staff. The specific aims were to: 1) evaluate the effectiveness and acceptability of a brief, preventive behavioural family intervention (BFI) administered by primary care staff in improving parenting skills and confidence and reducing targeted child behaviour problems; 2) assess the process of disseminating the intervention to primary care professionals by evaluating aids and obstacles for program implementation in the workplace; and 3) provide recommendations for future dissemination of psychological interventions. Childhood disruptive behaviour problems are becoming increasingly prevalent and are associated with significant personal and societal costs. Much is now known about the development of such problems, including individual, family and social risk and protective factors. There is considerable evidence that BFI programs are effective in reducing child behaviour problems and the family risk factors associated with the development and maintenance of these problems. Unfortunately, many evaluated programs have not been disseminated effectively, and have primarily been provided to clinical or high-risk populations in efficacy trials. Primary care settings have been increasingly identified as ideal settings for detection and early intervention for child mental health problems. However, there is limited research in the area of primary care BFI. While dissemination of psychological innovation to psychologists has historically been poor, with little impact on the professional practices of practitioners in the field, documentation of dissemination of these interventions to non-psychologists is rare. Although dissemination and diffusion theory have expanded, there is little controlled research evaluating the necessary or optimal conditions for the adoption and ongoing implementation of evidence-based programs. To address the problem of poor dissemination and limited access to evidence-based parenting programs in the community, a multilevel parenting and family support initiative, the Triple P-Positive Parenting Program, has been developed at the University of Queensland. One level of this system, Primary Care Triple P, encompasses a preventively oriented, early intervention program that aims to promote positive, caring relationships between parents and their children and to help parents develop effective management strategies for a variety of common behavioural and developmental issues. This primary care intervention was trialled and disseminated in the current research. Study 1 examined the effectiveness of Primary Care Triple P implemented by child health nurses with clients requesting help for child behaviour problems. A randomised group methodology was employed, comparing the intervention with a waitlist control condition. Assessments were completed at pre, post and 6-month follow-up. Data are presented for 26 families. In comparison to the waitlist condition, families receiving the intervention showed a significant reduction in targeted child behaviour problem/s according to monitoring and mother-report. Mothers receiving the intervention also reported significantly reduced dysfunctional parenting practices, greater satisfaction with their parenting role, and decreased anxiety and stress following the intervention in comparison to waitlist mothers. No group differences were found for observed parent-child interaction. However, rates of observed disruptive child behaviour and aversive parent behaviour were low from the outset. Consumer satisfaction with the program was high, and intervention gains were primarily maintained at 6-month follow-up. These results provide some of the first effectiveness outcomes from a randomised controlled trial of BFI in a primary care setting, and establish the effectiveness and acceptability of Primary Care Triple P conducted by child health nurses as part of usual practice. Study 2 examined the implementation of Primary Care Triple P following professional training in the program. Results of a survey of 1078 professionals are presented. A model of the personal, program, training and workplace factors influencing program implementation was tested. Structured equation modelling confirmed that practitioner self-efficacy mediated the relationship between program characteristics and program implementation. Prior professional experience and satisfaction with training did not predict self-efficacy or uptake. Workplace support was also directly associated with program implementation. These results advance our knowledge of the aids and obstacles faced by practitioners in implementing a new program in the workplace. This research provides important new knowledge in relation to improving early access to empirically-supported intervention services and has implications for the potential scope of service delivery in primary care settings. It also advances our understanding of the factors influencing a professional’s ability to implement a new intervention program following training. This information may inform the development of future dissemination efforts, allowing them to address necessary program, personal and workplace supports, and optimise program implementation following training.

This thesis presents a program of research evaluating the implementation of a primary care intervention program for disruptive child behaviour, and the process of dissemination of the intervention to primary care staff. The specific aims were to: 1) evaluate the effectiveness and acceptability of a brief, preventive behavioural family intervention (BFI) administered by primary care staff in improving parenting skills and confidence and reducing targeted child behaviour problems; 2) assess the process of disseminating the intervention to primary care professionals by evaluating aids and obstacles for program implementation in the workplace; and 3) provide recommendations for future dissemination of psychological interventions. Childhood disruptive behaviour problems are becoming increasingly prevalent and are associated with significant personal and societal costs. Much is now known about the development of such problems, including individual, family and social risk and protective factors. There is considerable evidence that BFI programs are effective in reducing child behaviour problems and the family risk factors associated with the development and maintenance of these problems. Unfortunately, many evaluated programs have not been disseminated effectively, and have primarily been provided to clinical or high-risk populations in efficacy trials. Primary care settings have been increasingly identified as ideal settings for detection and early intervention for child mental health problems. However, there is limited research in the area of primary care BFI. While dissemination of psychological innovation to psychologists has historically been poor, with little impact on the professional practices of practitioners in the field, documentation of dissemination of these interventions to non-psychologists is rare. Although dissemination and diffusion theory have expanded, there is little controlled research evaluating the necessary or optimal conditions for the adoption and ongoing implementation of evidence-based programs. To address the problem of poor dissemination and limited access to evidence-based parenting programs in the community, a multilevel parenting and family support initiative, the Triple P-Positive Parenting Program, has been developed at the University of Queensland. One level of this system, Primary Care Triple P, encompasses a preventively oriented, early intervention program that aims to promote positive, caring relationships between parents and their children and to help parents develop effective management strategies for a variety of common behavioural and developmental issues. This primary care intervention was trialled and disseminated in the current research. Study 1 examined the effectiveness of Primary Care Triple P implemented by child health nurses with clients requesting help for child behaviour problems. A randomised group methodology was employed, comparing the intervention with a waitlist control condition. Assessments were completed at pre, post and 6-month follow-up. Data are presented for 26 families. In comparison to the waitlist condition, families receiving the intervention showed a significant reduction in targeted child behaviour problem/s according to monitoring and mother-report. Mothers receiving the intervention also reported significantly reduced dysfunctional parenting practices, greater satisfaction with their parenting role, and decreased anxiety and stress following the intervention in comparison to waitlist mothers. No group differences were found for observed parent-child interaction. However, rates of observed disruptive child behaviour and aversive parent behaviour were low from the outset. Consumer satisfaction with the program was high, and intervention gains were primarily maintained at 6-month follow-up. These results provide some of the first effectiveness outcomes from a randomised controlled trial of BFI in a primary care setting, and establish the effectiveness and acceptability of Primary Care Triple P conducted by child health nurses as part of usual practice. Study 2 examined the implementation of Primary Care Triple P following professional training in the program. Results of a survey of 1078 professionals are presented. A model of the personal, program, training and workplace factors influencing program implementation was tested. Structured equation modelling confirmed that practitioner self-efficacy mediated the relationship between program characteristics and program implementation. Prior professional experience and satisfaction with training did not predict self-efficacy or uptake. Workplace support was also directly associated with program implementation. These results advance our knowledge of the aids and obstacles faced by practitioners in implementing a new program in the workplace. This research provides important new knowledge in relation to improving early access to empirically-supported intervention services and has implications for the potential scope of service delivery in primary care settings. It also advances our understanding of the factors influencing a professional’s ability to implement a new intervention program following training. This information may inform the development of future dissemination efforts, allowing them to address necessary program, personal and workplace supports, and optimise program implementation following training.

Research on the Berard Auditory Integration Training method has shown improvement in the regulation of attention, activity and impulsivity of children whose auditory system have been re-trained. Anecdotal reports have found improvements in sleeping patterns, balance, allergies, eyesight, eating patterns, depression and other seemingly unrelated physiological states. During the Auditory Integration Training (AIT) procedure dynamic music, with a wide range of frequencies, is processed through a system of filters in the AIT device. The volume and tone of the music is constantly and randomly modulated. The researcher explored Berard AIT as a possible intervention for learners between the ages of six and twelve years, who experienced problems with sustained attention and who have difficulty in shifting their attention from task to task. The aim was to investigate if Berard AIT method would enable the learner to stay calm, relaxed yet alert, with focused attention and thus concentration with appropriate reflection before action. An experimental quantative study, with a pretest-posttest control group design, was conducted to investigate the effect that Berard Auditory Integration Training has on learners with attention problems. Checklists and different measurements were conducted before the training started and repeated three months after the training was completed, to monitor if any change in the way that the learners pay attention, occurred the case group of ten learners was compared with ten learners in a control group who did not initially receive the intervention. Although the results of the post-tests varied amongst the learners, most learners in the experimental group experienced a statistical significant increase in attention control and a reduction in behavioural problems by the third month following the listening sessions. / Thesis (M.Ed.), North-West University, Vaal Triangle Campus, 2010

Research on the Berard Auditory Integration Training method has shown improvement in the regulation of attention, activity and impulsivity of children whose auditory system have been re-trained. Anecdotal reports have found improvements in sleeping patterns, balance, allergies, eyesight, eating patterns, depression and other seemingly unrelated physiological states. During the Auditory Integration Training (AIT) procedure dynamic music, with a wide range of frequencies, is processed through a system of filters in the AIT device. The volume and tone of the music is constantly and randomly modulated. The researcher explored Berard AIT as a possible intervention for learners between the ages of six and twelve years, who experienced problems with sustained attention and who have difficulty in shifting their attention from task to task. The aim was to investigate if Berard AIT method would enable the learner to stay calm, relaxed yet alert, with focused attention and thus concentration with appropriate reflection before action. An experimental quantative study, with a pretest-posttest control group design, was conducted to investigate the effect that Berard Auditory Integration Training has on learners with attention problems. Checklists and different measurements were conducted before the training started and repeated three months after the training was completed, to monitor if any change in the way that the learners pay attention, occurred the case group of ten learners was compared with ten learners in a control group who did not initially receive the intervention. Although the results of the post-tests varied amongst the learners, most learners in the experimental group experienced a statistical significant increase in attention control and a reduction in behavioural problems by the third month following the listening sessions. / Thesis (M.Ed.), North-West University, Vaal Triangle Campus, 2010

Behaviour problems are a problem in many secondary schools in Zimbabwe. This study attempts to investigate the causes and manifestations of behaviour problems of adolescent learners and to develop guidelines for teachers on how to assist learners with behaviour problems in the classroom. This is a qualitative study using focus group and semi-structured interviews. The main findings contributing to the causes of behaviour problems among adolescent learners are environmental factors, such as the family and the school and peer pressure. Behaviour problems are manifested by adolescents as disruptive behaviour, aggressive and antisocial behaviour, telling lies and theft. The findings highlight important guidelines, which teachers can use to assist and understand learners with behaviour problems in the classroom. The guidelines present an endeavour to solve problem behaviour in the classroom. / Educational Studies / M.Ed. (Special Needs Education)

Behaviour problems are a problem in many secondary schools in Zimbabwe. This study attempts to investigate the causes and manifestations of behaviour problems of adolescent learners and to develop guidelines for teachers on how to assist learners with behaviour problems in the classroom. This is a qualitative study using focus group and semi-structured interviews. The main findings contributing to the causes of behaviour problems among adolescent learners are environmental factors, such as the family and the school and peer pressure. Behaviour problems are manifested by adolescents as disruptive behaviour, aggressive and antisocial behaviour, telling lies and theft. The findings highlight important guidelines, which teachers can use to assist and understand learners with behaviour problems in the classroom. The guidelines present an endeavour to solve problem behaviour in the classroom. / Educational Studies / M.Ed. (Special Needs Education)

Learners with Attention Deficit Hyperactivity Disorder (ADHD) traditionally display disruptive and other associated negative behaviour in the classroom setting. Behaviour management strategies utilised by the teacher in the school environment can assist in reducing this type of behaviour that impacts negatively upon their academic performance. This research study develops and investigates the effectiveness of a programme of practical behaviour management strategies designed to reduce disruptive behaviour of learners with ADHD in the classroom. / Educational Studies / M. Ed. (Educational Psychology)

Problem behaviours amongst adolescent learners continue to affect the goals of effective education. The current study sought to investigate adolescents’ perspectives of discipline problems at a secondary school in Gauteng. A mixed method research design was followed during which questionnaires, focus groups and interviews directed the empirical investigation. The findings revealed two areas for addressing and improving the discipline problems of the secondary school, namely improving extrinsic factors and improving the current discipline system. Based on the findings, it was suggested that the school encourage greater parent involvement and improve parent-teacher communication. Creating a positive school identity and developing teachers further was proposed. An improved discipline system based on a positive learning approach was recommended. This included clarifying the discipline system to all role players, standardising discipline procedures throughout the school and improving follow up procedures regarding learner discipline. / Psychology of Education / M. Ed. (Guidance and Counselling)

South African adolescents are more likely to participate in high-risk behaviours, because they are exposed to high-risk environments that have a negative impact on them. The choices that adolescents make during this explorative life stage will influence and determine certain outcomes of their adult lives. Therefore, it is crucial to improve adolescents’ psychological well-being, as they are the future generation adults. Adolescents with behaviour problems form a unique population who do not respond effectively to traditional therapy, and researchers are continuously searching for more effective ways to reach this population. Equine-assisted therapy (EAT) is an intervention that has been proven to be effective with this population and to provide better outcomes than traditional psychotherapy. Although the value and positive effects of EAT has been proven, there is a gap in the literature concerning research on this topic, especially with regard to research conducted by means of quantitative methods. The overarching goal of this study was to evaluate and refine an EAT programme aimed at improving the psychological well-being of boys in a school of industry. This goal was attained by utilising a quantitative, experimental research design. The Solomon four-group design was applied, because it effectively controls pre-test sensitisation and provides the best control against threats to internal validity. The sample was selected from a school of industry near Bloemfontein, which provides residence to a group of adolescent boys who display behaviour problems. The 40 boys (N = 40) included in the sample were divided into two experimental groups of 10 boys each and two control groups of 10 boys each. During the course of the study, one of the boys withdrew and the sample was reduced to 39 boys. The programme was administered to the boys in the experimental groups. Before the programme commenced, one of the experimental groups and one of the control groups completed the pre-test. The psychometric instruments used were a biographical questionnaire, the Satisfaction with Life Scale and the Coping Orientations to the Problems Experienced Questionnaire. The boys then completed the EAT programme which consisted of eight sessions, each with its own outcomes and designed to improve subjective well-being and coping. After completion of the programme, all four groups completed the post-test consisting of the same psychometric instruments as the pre-test. The results showed that the programme significantly improved the boys’ subjective well-being. The boys’ problem-focused coping, emotion-focused coping and dysfunctional coping were also increased significantly. These improvements can be attributed directly to the programme, because pre-test sensitisation was controlled. The study found that the EAT programme had a significant positive effect on the boys’ subjective well-being and coping. The conclusion can be drawn that the programme significantly improved the boys’ psychological well-being. The programme was evaluated and refined, and recommendations were made for its future use. / PhD (Psychology), North-West University, Potchefstroom Campus, 2014

Le processus d’enseignement ne se limite pas à un ensemble de méthodes pédagogiques à appliquer et de contenus programmés à transmettre. Il se déploie également dans la construction par l’enseignant d’une relation pédagogique avec ses élèves. Cette relation est considérée comme étant optimale lorsqu’elle est caractérisée par un niveau élevé de chaleur et un faible niveau de conflits. Plusieurs études démontrent l’existence de liens significatifs entre la qualité de cette relation et les différents indicateurs d’adaptation à l’école. En général, les résultats des études démontrent l’influence positive d’une relation élève-enseignant chaleureuse sur le comportement des élèves, leur réussite scolaire ainsi que sur leurs sentiments et attitudes envers l’école. Certaines recherches soulignent également que l’incidence de la qualité de la relation élève-enseignant est particulièrement importante pour les élèves considérés à risque en raison de présence chez eux des certains facteurs de vulnérabilité tels que la pauvreté (facteurs sociaux), la relation parent-enfant difficile (facteurs familiaux) ou le manque d’habiletés sociales (facteurs individuels). La majorité de recherches ne permet toutefois pas de déterminer quels sont précisément les aspects de cette relation qui influencent significativement la qualité de la relation entre l’enseignant et ses élèves. Souhaitant pallier cette lacune, la présente étude poursuit deux objectifs : 1) examiner le lien entre les perceptions des élèves de niveau secondaire considérés à risque concernant les différents aspects de la qualité de la relation élève-enseignant et les problèmes de comportement extériorisés ; 2) vérifier si ce lien évolue avec le temps. Afin d’atteindre ces objectifs, nous avons pris en considération deux dimensions qui permettent de qualifier les profils de la relation élève-enseignant, soit la chaleur et les conflits (Pianta, 1992). La classification de ces deux dimensions en fonction de leur pôle positif et négatif permet de distinguer quatre profils relationnels que l’élève est susceptible d’établir avec ses enseignants soient le profil dit chaleureux, controversé, négligent ou conflictuel. II Cette étude repose sur un devis longitudinal grâce aux données recueillies dans le cadre de l’évaluation de la stratégie d’intervention Agir Autrement réalisée entre 2002 et 2008 (SIAA). Il s’agit donc ici d’analyses secondaires menées sur un échantillon aléatoire tiré de cette vaste recherche. Un échantillon de 563 élèves de 1re secondaire incluant 273 filles et 290 garçons a été constitué. Les analyses ont été effectuées auprès de ces élèves alors qu’ils étaient en premier et en cinquième année de secondaire ce qui a permis d’observer les changements dans le comportement des élèves à risque en fonction de la qualité de la relation élève-enseignant. De façon générale, les résultats obtenus montrent que les liens entre les différents profils de la relation élève-enseignant et les problèmes de comportement extériorisés sont fort complexes et loin d’être univoques. En particulier, ces résultats permettent de constater que le profil chaleureux représente le profil relationnel le moins associé aux problèmes de comportement extériorisés chez les élèves à risque et ce, autant en première qu’en cinquième secondaire. Selon nos résultats, les profils conflictuel et controversé sont significativement liés aux problèmes de comportement extériorisés chez les élèves à risque de 1re secondaire et de 5e secondaire. En ce qui a trait au profil négligent, les résultats de la présente recherche montrent l’existence d’un lien corrélationnel entre ce profil relationnel et les problèmes de comportement extériorisés. Toutefois, la force de l’association s’est avérée plus significative pour les élèves à risque en 5e secondaire secondaire comparativement aux mêmes élèves alors qu’ils étaient en 1re secondaire. Finalement, l’ensemble de résultats obtenus montre que les profils relationnels restent relativement stables dans le temps, tandis que la fréquence de comportements problématiques tels que le vol grave et la consommation de psychotropes augmentent d’une manière significative. De plus, les résultats que nous avons obtenus montrent l’existence d’un lien entre la dimension de conflits de la relation élève-enseignant et la consommation de substances psychotropes chez les élèves de notre échantillon. La présente recherche permet de constater que la dimension de conflits est aussi importante dans la relation élève-enseignant que la dimension de la chaleur, car les III conflits agiraient comme facteurs de risque pouvant augmenter la fréquence de problèmes de comportement extériorisés chez les élèves de secondaire considérés à risque. Ainsi, la réduction de niveau de conflits dans la relation entre les élèves et leurs enseignants peut jouer un rôle important en termes de prévention de ce type de problèmes chez les élèves de niveau secondaire. / Appling pedagogical methods and transmitting programmed material is not sufficient to define the complexity of teaching. The pedagogical relationship built by the teacher with his or her students is another important and necessary component. This relationship is considered optimal when it has a high level of warmth and a low level of conflicts. Previous studies demonstrate significant links between the quality of this relationship and different indicators of school-adaptations. In general, the reports reveal that a warm student-teacher relationship has a positive impact on student behaviour, academic success as well as feelings and attitudes toward school. Furthermore, the quality of student-teacher relationship has an even greater effect on students considered at risk. This student category is characterised by the presence of vulnerability factors such as poverty (social factors), difficult parent-child relationship (family factors) or a lack of social skills (individual factors). Majority of research done on student-teacher relationship does not specify which aspects in particular have a significant influence on its overall quality. In order to address this issue, two goals are aimed by the present study: 1) examine the relationship between perceptions of high school students considered at risk for various aspects of the quality of the student-teacher relationship and externalizing behavior problems; 2) verification if this link evolves over time. In our work, the type of student-teacher relationship is categorized by two dimensions: the warmth and the conflicts (Pianta, 1992). The classification according to the positive or negative pole of each dimension enables to distinguish between four types of relations the student is prone to establish with his or her teachers: either warm, controversial, negligent or conflict. A random sample of the data collected in 2002-2008 during the evaluation of intervention strategy Agir Autrement (Act Differently) (SIAA) is used in the present longitudinal study. It is composed of 563 high school students: 273 girls and 290 boys. V Secondary analyses are made on the data collected on the same students during their first and fifth year. This approach gives the opportunity to observe the changes in student behaviour as function of student-teacher relationship quality. In general, our results show a high complexity of links between different types of student-teacher relationship and the exteriorized behaviour problems. More specifically, we conclude that a warm type relation is less likely to be associated with exteriorized behaviour problems of students at risk, and that as much in 1st year of high school as in the 5th. According to our results, conflict and controversial relationship types are significantly linked to exteriorized behaviour problems of students at risk in the 1st and the 5th year of high school. In the case of the negligent relationship, the results demonstrate the existence of a correlation between this bond type and exteriorized behaviour problems. However, the strength of this correlation is higher for the students at risk in the 5th year of high school as compared to the same students when they were in their 1st year. Finally, when all the results are taken together, they reveal the relative stability of the relationship type over time and on the other hand, a significant increase in the frequency of problematic behaviour such as serious stealing and psychotropic consumption. Furthermore, the obtained results show the existence of a link between the conflict dimension of the student-teacher relationship and the psychotropic consumption of students accounted by our sample. The present study demonstrates that since conflicts act as risk factors capable of increasing the frequency of exteriorized behaviour problems of high school students considered at risk, the conflict dimension is equally important in the student-teacher relationship as the warmth dimension. A relationship between students and their teachers with a reduced level of conflicts can play an important role in the prevention of this type of problems experienced by high school students.