The Society for Clinical Child and Adolescent Psychology (SCCAP): Initiative for Dissemination of Evidence-based Treatments for Childhood and Adolescent Mental Health Problems With additional support from Florida International University and The Children’s Trust.
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The Society for Clinical Child and Adolescent Psychology ... · • Curriculum of Parent Training Programs • Evidence from Meta Analyses ... Focused Programs More Effective ...
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The Society for Clinical Child and Adolescent Psychology (SCCAP):
Initiative for Dissemination of Evidence-based Treatments for Childhood and Adolescent
Mental Health Problems
With additional support from Florida International University and The Children’s Trust.
Keynote Evidence-based Parenting Programs for the Treatment of Children with Externalizing Problems
Charles E. Cunningham, Ph.D. Department of Psychiatry & Behavioural Neurosciences
Jack Laidlaw Chair in Patient-Centred Health Care Faculty of Health Sciences
Michael G. DeGroote School of Medicine McMaster University
Goals of the Presentation
• Overview Parent Training for Externalizing Problems
• Learning Process
• Curriculum of Parent Training Programs
• Evidence from Meta Analyses
• Efficacy of Parenting Programs
• Efficacy of Training Components
• Efficacy of Curriculum Components
• Promising Directions
The Evolution of Social Learning Parent Training Programs (Selected)
Community Parent Education Program (Cunningham, 1995)
Triple P (Sanders, 1999)
Hanf’s 2 Stage Program (1973)
Helping the Noncompliant Child (Forehand & McMahon 1981)
Defiant Children (Barkley, 1987)
Parent-Child Interaction Program (Eyberg)
Incredible Years (Webster-Stratton, 1988)
Social Learning Parenting Programs: Common Learning Processes
• Homework Review
• Modeling (Live or Videotaped)
• Role Playing or Practice w/ Child
• Homework Goal Setting
• Public Posting
• Self Monitoring
• Readings (e.g. Social Learning Principles)
Parenting Programs: Common Evidence-Based Curriculum
Utilization of Group Parent Training: Prospectively Screened Samples
Cunningham et al., Journal of Child Psychology & Psychiatry (2007) Cunningham et al., Journal of Consulting & Clinical Psychology (2000) Barkley et al., Journal of Abnormal Child Psychology (2000)
Preferred Program Format (n= 1060)
-40
-30
-20
-10
0
10
20
30
40
Internet E-Mail Phone Face to Face
Utility
Valu
e
Segment 1 Segment 2 Segment 3
Phone Contacts Preferred by Segments 2 (17%) & 3 (35%)
Segment 1 (48%) Prefers Face to Face Services
Source: Cunningham et al. In preparation (2008)
Self Directed Readings Plus Therapist Support
69 Families of Preschoolers from Germany
10 Chapter Triple P Parenting Book
Video Demonstrating Parenting Skills
7 Telephone Conversations with Facilitator
Therapist-Supported Bibliotherapy: Impact on Externalizing Problems
0.11
0.83
0
0.2
0.4
0.6
0.8
1
Eff
ect
Siz
e1
Control SDPT+T
Source: Hahlweg et al., Behavior Modification (2010)
1(Pretest Mean-Post Test Mean)/SD Difference
Self Directed Parent Training Plus Therapist Phone Support Reduced
Externalizing Problems
Therapist-Supported Bibliotherapy: Impact on Internalizing Problems
0.05
0.51
0
0.2
0.4
0.6
0.8
1
Eff
ect
Siz
e1
Control SDPT+T
Source: Hahlweg et al., Behavior Modification (2010)
1(Pretest Mean-Post Test Mean)/SD Difference
Self Directed Parent Training Plus Therapist Phone Support Reduced
Internalizing Problems
Limitations
Meta Analyses are Not Experimental Manipulations
Most Reviews Focus on Parents of Young Children
Conclusions
Parent Training Effective for Externalizing Problems
Broad Outcomes (e.g., Internalizing Problems)
Focused Programs More Effective
Parent & Family Risk Factors Moderate Outcome
Many Parents Do Not Use Available Programs
Fathers Benefit & Improve Short Term Outcomes
Design Factors Influence Utilization
New Delivery Modes May Reduce Barriers
For more information, please go to the main website and browse for workshops on this topic or check out our additional resources.
Additional Resources Online resources: 1. COPE website: http://www.rfts.ca/cope/index.html 2. Society of Clinical Child and Adolescent Psychology website: http://effective childtherapy.com 3. Center for Children and Families website: http://ccf.fiu.edu
Books: 1. Barkley, R. A (Ed.) . (2005). Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. New York: Guilford Press. 2. Weisz, J.R., & Kazdin, A.E. (Eds.). (2010). Evidence-based psychotherapies for children and adolescents. New York: Guilford Press.
Peer-reviewed Journal Articles: 1. Dretzke, J., Davenport, C., Frew, E., Barlow, J., Stewart-Brown, S., Bayliss, S., Taylor, R.S., Sndercock, J., & Hyde, C. (2009). The clinical effectiveness of different parenting programmes for children with conduct problems: A systematic review of randomized controlled trials. Child and Adolescent Psychiatry & Mental Health, 3, 7. 2. Kaminski, J. W., Valle, L. A., Filene, J. H., & Boyle, C. (2008). A meta-analytic review of components associated with parent training program effectiveness. Journal of Abnormal Child Psychology, 36, 567-589. 3. Maughan, D. R., Christiansen, E., Jenson, W. R., Olympia, D., & Clark, E. (2005). Behavioral parent training as a treatment for externalizing behaviors and disruptive behavior disorders: A meta-analysis. School Psychology Review, 34, 267-286. 4. Reyno, S. M. & McGrath, P. J. (2006). Predictors of parent training efficacy for child externalizing behavior problems – a meta-analytic review. Journal of Child Psychology & Psychiatry, 47, 99-111.
Full Reference List Full reference list with additional information on evidence-based parenting programs for children with disruptive behavior. Websites: 1. COPE website: http://www.rfts.ca/cope/index.html 2. Society of Clinical Child and Adolescent Psychology website: http://effective childtherapy.com 3. Center for Children and Families: http://casgroup.fiu.edu/CCF/index.php Books: Barkley, R.A. (1987). Defiant children: A clinician's guide to parent training. New York: Guilford. Barkley, R. A (Ed.) . (2005). Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and
Treatment. New York: Guilford Press. Cohen, J. (Eds.). (1988). Statistical Power Analysis for the Behavioral Sciences. New Jersey: Lawrence
Erlbaum Associates Inc. Forehand, R. L., & McMahon, R. J. (1981). Helping the noncompliant child: A clinician's guide to parent
training. New York: Guilford Press. Webster-Stratton, C. (Ed.). (1984). The Incredible Years Parent Training Manual: BASIC Program. Weisz, J.R., & Kazdin, A.E. (Eds.). (2010). Evidence-based Psychotherapies for Children and Adolescents.
New York: Guilford Press. Peer-reviewed Journal Articles: Cunningham, C. E., Boyle, M., Offord, D., Racine, Y., & Hundert, J., Secord, M. & McDonald, J. (2000). Tri
Ministry Project: Correlates of school-based parenting course utilization. Journal of Consulting and Clinical Psychology, 68 (5), 928-933.
Cunningham, C. E., Bremner, B., & Boyle, M. (1995). Large group school-based courses for parents of preschoolers at risk for disruptive behaviour disorders: Utilization, outcome, and cost effectiveness. Journal of Child Psychology and Psychiatry, 36, 1141-1159.
Cunningham, C. E., Deal, K., Rimas, H., Buchanan, D. H., Gold, M., Sdao-Jarvie, K., et al. (2008). Modeling the information preferences of parents of children with mental health problems: a discrete choice conjoint experiment. Journal of Abnormal Child Psychology, 7(36), 1128–1138.
Dretzke, J., Davenport, C., Frew, E., Barlow, J., Stewart-Brown, S., Bayliss, S., Taylor, R.S., Sndercock, J., & Hyde, C. (2009). The clinical effectiveness of different parenting programmes for children with conduct problems: A systematic review of randomized controlled trials. Child and Adolescent
(Link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660289/?tool=pmcentrez) Hahlweg, K., Heinrichs, N., Kuschel, A., & Feldmann, M. (2008). Therapist assisted self-administered
bibliotherapy to enhance parental competence: Short- and long-term effects. Behavior Modification, 32 (5), 659-681.
Kaminski, J. W., Valle, L. A., Filene, J. H., & Boyle, C. (2008). A meta-analytic review of components associated with parent training program effectiveness. Journal of Abnormal Child Psychology, 36, 567-589.
Lundahl, B. W., Tollefson, D., Risser, H., & Lovejoy, M. C. (2008). A meta-analysis of father involvement in parent training. Research on Social Work Practice, 18(2), 97–106.
Maughan, D. R., Christiansen, E., Jenson, W. R., Olympia, D., & Clark, E. (2005). Behavioral parent training as a treatment for externalizing behaviors and disruptive behavior disorders: A meta- analysis. School Psychology Review, 34, 267-286.
Reyno, S. M. & McGrath, P. J. (2006). Predictors of parent training efficacy for child externalizing behavior problems – a meta-analytic review. Journal of Child Psychology & Psychiatry, 47, 99-
111. Sanders, M. R. (1999). Triple P-Positive Parenting Program: Towards an empirically validated multilevel
parenting and family support strategy for the prevention of behavior and emotional problems in children. Clinical Child & Family Psychology Review, 2, 71-90.
Webster-Stratton, C., & Hammond, M. (1997). Treating children with early-onset conduct problems: A comparison of child and parent training interventions. Journal of Consulting and Clinical Psychology, 65(1), 93-109.
Other: Hanf, C., & Kling, F. (1973). Facilitating parent-child interaction: A two-stage training model.
Unpublished manuscript, University of Oregon Medical School. Retrieved from http://www.EffectiveChildTherapy.fiu.edu