Step-by-Step: Stepped care for children with defiant or aggressive behavior

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

The program begins with a brief internet-based parenting support course ('Step 1') for families of children aged 8–16 who show defiant or aggressive behaviors. Families whose problems persist are offered Step 2, which may be CBT delivered with virtual-reality support for either the parent or the child, or standard clinic-based interventions plus continued online support, with the option to later choose CBT-VR. Outcomes include changes in child aggressive and oppositional behaviors, treatment engagement, and feasibility of using a stepped approach. The project is coordinated by Karolinska Institutet and Region Stockholm and requires participants to engage with materials in Swedish.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Families with children aged 8-16 years who have difficulty controlling anger or exhibit defiant or aggressive behavior. The child/adolescent meets 3 of the diagnostic criteria for Oppositional Defiant Disorder or 2 criteria for Conduct Disorder indicating aggressive behavior.
* Medication for the child can remain stable.
* Parents need to be able to read and engage with materials in Swedish

Exclusion Criteria:

* Families with children younger than 8 years old or who have already turned 17, or who do not exhibit defiant or aggressive behaviors according to the first inclusion criterion.
* Children with severe depression, suicidal behavior, bipolar disorder, psychosis, eating disorders, severe autism (level 2 and 3), diagnosed intellectual disability, or ongoing criminal behavior assessed to require interventions other than the study's interventions are excluded.
* Children/adolescents with other ongoing psychological treatments for the same condition or assessed by the clinician in need of other interventions
* Parents and children with epilepsy or migraines

Where it's running

• Karolinska Institutet
  Solna, Sweden Recruiting

Study contacts

• Principal investigator: Pia Enebrink, PhD — Karolinska Institutet
• Study coordinator: Pia Enebrink, PhD
• Email: pia.enebrink@ki.se
• Phone: +46852487738

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.