A randomized controlled trial of regulation-focused psychotherapy for children with externalizing disorders

Objective This study evaluated the efficacy of Regulation-Focused Psychotherapy for Children (RFP-C), a manualized time-limited psychodynamic treatment for externalizing disorders targeting implicit emotion regulation.Method Eighty Turkish children (Mage = 8.53 years, 71.25% male) with externalizing disorders were randomized to RFP-C or an active control, a parenting and child social skills group (PSSG). Primary outcomes were externalizing and oppositional defiant disorder (ODD) problems. Secondary outcomes were child-reported problems, global functioning, child and parent emotion regulation, and parenting stress. Assessments occurred at baseline, mid-treatment, post-treatment (primary endpoint), and 6-month follow-up.Results RFP-C was superior to PSSG in reducing broad externalizing problems at post-treatment with a small-to-moderate effect (d = −.47, 97.5% CI [−.87, −.07]). This effect attenuated (d = −.34, 97.5% CI [−.75, .06]) and was no longer significant at follow-up. No significant treatment effects emerged for ODD symptoms. RFP-C was also superior for child global functioning (d = .57, 95% CI [.30, .84]) and parenting stress (d = −.36, 95% CI [−.70, −.02]) at post-treatment, with the latter no longer significant at follow-up. No other between-group differences were significant.Conclusion RFP-C showed superior effects in reducing broad externalizing problems at post-treatment; however, further research should clarify its effects on ODD symptoms and the durability of treatment gains.