{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:19:39Z","timestamp":1781133579907,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Psychology Psychiatry"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Empirical evidence supports the efficacy of behavioral online parent training. However, further large trials in school\u2010age children with externalizing behavior problems and analyses on the impact of additional therapist support are needed. This three\u2010arm randomized controlled trial examined the efficacy of guided and unguided web\u2010assisted self\u2010help (WASH) for parents of children with externalizing behavior problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Parents of 431 children (6\u201312\u2009years) with elevated externalizing symptoms were randomly assigned to either treatment as usual (TAU), a 6\u2010month behavioral WASH intervention (WASH+TAU), or WASH plus telephone\u2010based support (WASH+S+TAU). Assessments took place at baseline and at 3, 6, and 12\u2009months. The primary outcome was child externalizing symptoms as rated by a clinician blinded to condition; secondary outcomes were parent\u2010rated child externalizing symptoms, internalizing symptoms, functional impairment, quality of life, parenting practices, and parental internalizing symptoms. (German Clinical Trials Register (DRKS): DRKS00013456; URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/drks.de\/search\/de\/trial\/DRKS00013456\">https:\/\/drks.de\/search\/de\/trial\/DRKS00013456<\/jats:ext-link>\n                      ; registered on January 3rd 2018).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Linear mixed models for repeated measures revealed a significant overall intervention effect on blinded clinician\u2010rated externalizing symptoms at 6\u2009months in both the intention\u2010to\u2010treat sample and per\u2010protocol samples, with at least 25% (PP25) or 40% treatment utilization (PP40), respectively (intention\u2010to\u2010treat:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.017). Subsequent pairwise comparisons revealed a greater symptom reduction in WASH+S+TAU than in the other conditions (intention\u2010to\u2010treat: WASH+S+TAU vs. WASH+TAU:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.029,\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u2009\u22120.28, 95% CI [\u22120.54, \u22120.03]; WASH+S+TAU vs. TAU:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.009,\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.34 [\u22120.59, \u22120.09]). At 12\u2009months, a significant overall effect on blinded clinician\u2010rated externalizing symptoms only emerged in the PP40 sample (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.035). Secondary analyses revealed an overall effect on child functional impairment at 12\u2009months (intention\u2010to\u2010treat and per\u2010protocol analyses) and on negative parenting behaviors at 6\u2009months in the PP40 sample. For both variables, pairwise comparisons demonstrated significant differences between WASH+S+TAU and TAU.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Parent\u2010directed WASH is effective in reducing blinded clinician\u2010rated externalizing symptoms, but only when combined with additional support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpp.14153","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T21:00:02Z","timestamp":1741726802000},"page":"1320-1332","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Efficacy of guided and unguided web\u2010assisted self\u2010help for parents of children with attention\u2010deficit\/hyperactivity disorder and oppositional defiant disorder: A three\u2010arm randomized controlled trial"],"prefix":"10.1111","volume":"66","author":[{"given":"Manfred","family":"D\u00f6pfner","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"},{"name":"Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Pl\u00fcck","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"},{"name":"Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin Daniela","family":"Rosenberger","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology (IMSB) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Theres","family":"Klemp","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"M\u00fchlenmeister","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"W\u00e4hnke","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Hellmich","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, Institute of Medical Statistics and Computational Biology (IMSB) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Sch\u00fcrmann","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne University of Cologne  Cologne Germany"},{"name":"Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Dose","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and University Hospital Cologne, School for Child and Adolescent Cognitive Behavior Therapy (AKiP) University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Manual for the ASEBA school\u2010age forms and profiles","author":"Achenbach T.M.","year":"2001"},{"key":"e_1_2_11_3_1","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen 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(2018).Long version of the interdisciplinary evidence\u2010 and consensus\u2010based (S3) guideline \u201cAttention\u2010Deficit\/Hyperactivity Disorder (ADHD) in children adolescents and adults\u201d. AWMF Registration No. 028\u2010045. Available fromhttps:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/028\u2010045k_S3_ADHS_2018\u201006.pdf"},{"key":"e_1_2_11_7_1","volume-title":"Diagnostik\u2010System f\u00fcr Psychische St\u00f6rungen nach ICD\u201010 und DSM\u20105 f\u00fcr Kinder und Jugendliche \u2013 III [Diagnostic system for mental disorders in childhood and adolescence according to ICD\u201010 and DSM\u20105]","author":"D\u00f6pfner M.","year":"2017"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1087054718810797"},{"key":"e_1_2_11_9_1","volume-title":"Elternfragebogen \u00fcber das Verhalten von Kindern und Jugendlichen (CBCL\/6\u201018R). Deutschsprachige Fassung der Child Behavior Checklist for Ages 6\u201318 von Thomas M. 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Hilfen f\u00fcr Eltern bei ADHS\u2010Symptomen, hyperkinetischem und oppositionellem Verhalten [Help for parents of children with ADHD symptoms, hyperkinetic and oppositional problem behaviors]","author":"D\u00f6pfner M.","year":"2017"},{"key":"e_1_2_11_11_1","volume-title":"Therapieprogramm f\u00fcr kinder mit hyperkinetischem und oppositionellem Problemverhalten [Therapy program for parents of children with hyperkinetic and oppositional problem behavior]","author":"D\u00f6pfner M.","year":"2019"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-020-2481-0"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12661"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2012.01.006"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2023.01.019"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10567-020-00326-0"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-29550-z"},{"key":"e_1_2_11_18_1","volume-title":"Interviewleitf\u00e4den zum Diagnostik\u2010System f\u00fcr psychische St\u00f6rungen f\u00fcr Kinder\u2010 und Jugendliche (DISYPS\u2010III\u2010ILF) [Clinical interview for the diagnostic system for mental disorders in childhood and adolescence]","author":"G\u00f6rtz\u2010Dorten A.","year":"2021"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-024-00850-9"},{"key":"e_1_2_11_20_1","unstructured":"Imort S. 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