skip to main content
Washington State Institute for Public Policy
Back Button

Choice Theory/Reality Therapy for children with disruptive behavior

Children's Mental Health: Disruptive Behavior
  Literature review updated July 2018.

Choice Theory/Reality Therapy (CT/RT) is a program for parents of elementary students with repeated disciplinary referrals, typically three or more referrals during one school year. These referrals were due to a child’s defiance and/or physical or verbal abuse towards others. The program is delivered by a trained therapist in nine 90-minute weekly parent training group lessons. CT/RT provides both instructional handouts and homework for the parents. The program focuses on responding to the child's needs, teaching self-control by example, and parenting in an authoritative way (rather than an authoritarian or a permissive way). Authoritative parenting sets limits in keeping with the child’s development and creates a supportive environment in the home.
 
ALL
META-ANALYSIS
CITATIONS

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the program impacts measured in the research literature (for example, impacts on crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information on how we estimate effect sizes.

The effect size may be adjusted from the unadjusted effect size estimated in the meta-analysis. Historically, WSIPP adjusted effect sizes to some programs based on the methodological characteristics of the study. For programs reviewed in 2024 or later, we do not make additional adjustments, and we use the unadjusted effect size whenever we run a benefit-cost analysis.

Research shows the magnitude of effects may change over time. For those effect sizes, we estimate outcome-based adjustments, which we apply between the first time ES is estimated and the second time ES is estimated. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured No. of effect sizes Treatment N Effect sizes (ES) and standard errors (SE) Unadjusted effect size (random effects model)
ES SE Age ES p-value
Disruptive behavior disorder symptoms
Clinical diagnosis of a disruptive behavior disorder (e.g., conduct disorder, oppositional defiant disorder) or symptoms measured on a validated scale.
 9 1 15 -0.110 0.372 9 -0.479 0.212
Internalizing symptoms
Symptoms of internalizing behavior (e.g., sadness, anxiety, or withdrawal) measured on a validated scale.
 9 1 15 -0.101 0.372 9 -0.441 0.248
Office discipline referrals
Referrals of a student to an administrative office for disciplinary reasons.
9 1 15 -0.215 0.373 9 -0.938 0.017

Citations Used in the Meta-Analysis

Petra, J.R. (2000). The effects of a choice theory and reality therapy parenting program on children's behavior. (Doctoral Dissertation). The Union Institute Graduate College.