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Two-Year Findings from a National Effectiveness Trial: Effectiveness of Behavioral and Non-Behavioral Parenting Programs

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Abstract

Long-term follow-up studies of selective parent training (PT) programs are scarce, particularly in the case of effectiveness trials conducted within regular care settings. This study evaluated the 2-year effects of 4 programs: Comet, Incredible Years, Cope, and Connect and differences in the rate of change among programs were investigated using Latent Growth Modeling (LGM). Participants were parents who had sought help at 30 local service sector units (e.g., child psychiatric clinics and social services centers) for major problems in managing their children’s externalizing behavior. Parents of 749 children (63 % boys) with moderate levels of externalizing behavior, aged 3–12, were randomized to one of the 4 PT programs. Assessments included parent-reported measures of child externalizing, hyperactivity and inattention, as well as parenting practices, sense of competence, and parents’ stress and depressive symptoms. At 2-year follow-up, there were no differences in any of the child outcomes among the programs. All programs had reduced externalizing behaviors with large effect sizes (d = 1.21 to d = 1.32), and negative parenting practices with moderate to large effect sizes (d = 0.49 to d = 0.83). LGM analyses showed that the 2 behavioral programs, Comet and Incredible Years, produced more rapid reductions in externalizing behavior during the course of the intervention than the non-behavioral program, Connect. Connect, however, was the only program where children continued to improve after the intervention. Overall, the results indicate that the 4 programs were equally effective in a clinical setting, despite differences in their theoretical origin.

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References

  • Alda, J. A., & Serrano-Troncoso, E. (2013). Attention-deficit hyperactivity disorder: agreement between clinical impression and the SNAP-IV screening tool. Actas Espanolas de Psiquiatria, 41, 76–83.

    PubMed  Google Scholar 

  • Axberg, U., Hanse, J. J., & Broberg, A. G. (2008). Parents' description of conduct problems in their children: a test of the Eyberg child behavior inventory (ECBI) in a Swedish sample aged 3-10. Scandinavian Journal of Psychology, 49, 497–505. doi:10.1111/J.1467-9450.2008.00670.X.

    Article  PubMed  Google Scholar 

  • Barkley, R. A. (1997). Defiant children: A clinician's manual for assessment and parent training. New York, NY: Guilford Press.

  • Brannan, A., Helflinger, A., & Brickman, L. (1997). The caregiver strain questionnaire: measuring the impact on the family of living with a child with severe emotional disturbance. Journal of Emotional and Behavioral Disorders, 5, 212–222.

    Article  Google Scholar 

  • Bywater, T., Hutchings, J., Daley, D., Whitaker, C., Yeo, S. T., Jones, K., et al. (2009). Long-term effectiveness of a parenting intervention for children at risk of developing conduct disorder. British Journal of Psychiatry, 195, 318–324. doi:10.1192/bjp.bp.108.056531.

    Article  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2 ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.

  • Cunningham, C. E., Davis, J. R., Bremner, R., Dunn, K. W., & Rzasa, T. (1993). Coping modeling problem-solving versus mastery modeling: effects on adherence, in-session process, and skill acquisition in a residential parent-training program. Journal of Consulting and Clinical Psychology, 61, 871–877. doi:10.1037//0022-006x.61.5.871.

    Article  PubMed  Google Scholar 

  • Cunningham, C. E., Bremner, R., & Boyle, M. (1995). Large group community-based parenting programs for families of preschoolers at risk for disruptive behavior disorders: utilization, cost-effectiveness, and outcome. Journal of Child Psychology and Psychiatry and Allied Disciplines, 36, 1141–1159. doi:10.1111/j.1469-7610.1995.tb01362.x.

    Article  Google Scholar 

  • DeGarmo, D. S., & Forgatch, M. S. (2005). Early development of delinquency within divorced families: evaluating a randomized preventive intervention trial. Developmental Science, 8, 229–239. doi:10.1111/j.1467-7687.2005.00412.x.

    Article  PubMed  Google Scholar 

  • DeGarmo, D. S., Patterson, G. R., & Forgatch, M. S. (2004). How do outcomes in a specified parent training intervention maintain or wane over time? Prevention Science, 5, 73–89. doi:10.1023/B:PREV.0000023078.30191.e0.

    Article  PubMed  Google Scholar 

  • Duncan, T. E., Duncan, S. C., & Strycker, L. A. (2013). An introduction to latent variable growth curve modeling: Concepts, issues, and application. Mahwah, NJ: Routledge Academic.

  • Eisner, M., Nagin, D., Ribeaud, D., & Malti, T. (2012). Effects of a universal parenting program for highly adherent parents: a propensity score matching approach. Prevention Science, 13, 252–266. doi:10.1007/s11121-011-0266-x.

    Article  PubMed  Google Scholar 

  • Eyberg, S., & Pincus, D. (1999). Eyberg Child Behavior Inventory and Sutter-Eyberg Student Behavior Inventory-Revised: Professional manual. Odessa, FL: Psychological Assessment Resources.

  • Forgatch, M. S. (1994). Parenting through change: A programmed intervention curriculum for groups of single mothers. Eugene, OR: Oregon Social Learning Center.

  • Furlong, M., McGilloway, S., Bywater, T., Hutchings, J., Smith, S. M., & Donnelly, M. (2012). Behavioural and cognitive-behavioural group-based parenting programmes for early-onset conduct problems in children aged 3 to 12 years. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD008225.pub2.

    PubMed  Google Scholar 

  • Gardner, F., Burton, J., & Klimes, I. (2006). Randomised controlled trial of a parenting intervention in the voluntary sector for reducing child conduct problems: outcomes and mechanisms of change. Journal of Child Psychology and Psychiatry, 47, 1123–1132. doi:10.1111/j.1469-7610.2006.01668.x.

    Article  PubMed  Google Scholar 

  • Gilmore, L., & Cuskelly, M. (2009). Factor structure of the parenting sense of competence scale using a normative sample. Child: Care, Health and Development, 35, 48–55. doi:10.1111/j.1365-2214.2008.00867.x.

    Google Scholar 

  • Hahlweg, K., Heinrichs, N., Kuschel, A., Bertram, H., & Naumann, S. (2010). Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort? Child and Adolescent Psychiatry and Mental Health, 4, 14. doi:10.1186/1753-2000-4-14.

    Article  PubMed  PubMed Central  Google Scholar 

  • Johnston, C., & Mash, E. (1989). A measure of parenting satisfaction and efficacy. Journal of Child & Adolescent Psychology, 18, 167–175.

    Article  Google Scholar 

  • Kazdin, A. E. (2003). Research design in clinical psychology (Vol. 3). Boston, MA: Allyn and Bacon Boston.

  • Kazdin, A. E. (2013). Evidence-based treatment and usual care cautions and qualifications. JAMA Psychiatry, 70, 666–667. doi:10.1001/jamapsychiatry.2013.2112.

    Article  PubMed  Google Scholar 

  • Kling, Å., Sundell, K., Melin, L., & Forster, M. (2006). Komet för föräldrar: en randomiserad effektutvärdering av ett föräldraprogram för barns beteendeproblem [comet for parents: a randomized evaluation of a parenting program for child behavior problems]: Stockholms Socialtjänstförvaltning: FoU-enheten.

    Google Scholar 

  • Kling, A., Forster, M., Sundell, K., & Melin, L. (2010). A randomized controlled effectiveness trial of parent management training with varying degrees of therapist support. Behavior Therapy, 41, 530–542. doi:10.1016/j.beth.2010.02.004.

    Article  PubMed  Google Scholar 

  • Lindsay, G., & Strand, S. (2013). Evaluation of the national roll-out of parenting programmes across England: the parenting early intervention programme (PEIP). BMC Public Health, 13. doi:10.1186/1471-2458-13-972.

  • Litschge, C. M., Vaughn, M. G., & McCrea, C. (2010). The empirical status of treatments for children and youth with conduct problems: an overview of meta-analytic studies. Research on Social Work Practice, 20, 21–35. doi:10.1177/1049731508331247.

    Article  Google Scholar 

  • Losel, F., & Stemmler, M. (2012). Preventing child behavior problems in the Erlangen-Nuremberg development and prevention study: results from preschool to secondary school age. International Journal of Conflict and Violence, 6, 214–224.

    Google Scholar 

  • Lundahl, B., Risser, H., & Lovejoy, M. (2006). A meta-analysis of parent training: moderators and follow-up effects. Clinical Psychology Review, 26, 86–104. doi:10.1016/j.cpr.2005.07.004.

    Article  PubMed  Google Scholar 

  • Malti, T., Ribeaud, D., & Eisner, M. P. (2011). The effectiveness of two universal preventive interventions in reducing children's externalizing behavior: a cluster randomized controlled trial. Journal of Clinical Child and Adolescent Psychology, 40, 677–692. doi:10.1080/15374416.2011.597084.

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • Moretti, M. M., & Obsuth, I. (2009). Effectiveness of an attachment-focused manualized intervention for parents of teens at risk for aggressive behaviour: the connect program. Journal of Adolescence, 32, 1347–1357. doi:10.1016/j.adolescence.2009.07.013.

    Article  PubMed  Google Scholar 

  • Moretti, M. M., Braber, K., & Obsuth, I. (2013). Connect: An Attachment-focused treatment group for parents and caregivers – A principle based manual. Burnaby, BC: Simon Fraser University.

  • Muthén, L. K., & Muthén, B. O. (1998-2012). Mplus user’s guide. (7th ed.). Los Angeles, CA: Muthén & Muthén.

  • National Institute for Health and Clinical Excellence. (2013). Antisocial behaviour and conduct disorders in children and young people: recognition, intervention and management. NICE clinical guideline 158. Retrieved from http://www.nice.org.uk/guidance/cg158.

  • Özdemir, M. (2015). How much do we know about the long-term effectiveness of parenting programmes? Advances, shortcomings, and future directions. Journal of Children's Services, 10, 120–132. doi:10.1108/JCS-02-2014-0016.

    Article  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306.

    Article  Google Scholar 

  • Reinecke, J., & Weins, C. (2013). The development of delinquency during adolescence: a comparison of missing data techniques. Quality & Quantity, 47, 3319–3334. doi:10.1007/s11135-012-9721-4.

    Article  Google Scholar 

  • Robinson, E., Eyberg, S., & Ross, A. (1980). The standardization of an inventory of child conduct problem behaviors. Journal of Clinical Child & Adolescent Psychology, 9, 22–28.

    Article  Google Scholar 

  • Sandler, I. N., Schoenfelder, E. N., Wolchik, S. A., & MacKinnon, D. P. (2011). Long-term impact of prevention programs to promote effective parenting: lasting effects but uncertain processes. Annual Review of Psychology, 62, 299–329. doi:10.1146/annurev.psych.121208.131619.

    Article  PubMed  PubMed Central  Google Scholar 

  • SBU. (2010). Program för att förebygga psykisk ohälsa hos barn. En systematisk litteraturöversikt [Methods to Prevent Mental ill-Health in Children. A Systematic Review]. (SBU-report 202). Retrieved january 27th 2014, from Swedish Council on Health Technology Assessment http://www.sbu.se/sv/Publicerat/Gul/Program-for-att-forebygga-psykisk-ohalsa-hos-barn/.

  • Schafer, J. L., & Graham, J. W. (2002). Missing data: our view of the state of the art. Psychological Methods, 7, 147–177. doi:10.1037//1082-989x.7.2.147.

    Article  PubMed  Google Scholar 

  • Serketich, W. J., & Dumas, J. E. (1996). The effectiveness of behavioral parent training to modify antisocial behavior in children: a meta-analysis. Behavior Therapy, 27, 171–186.

    Article  Google Scholar 

  • Stattin, H., Persson, S., Burk, W. J., & Kerr, M. (2011). Adolescents’ perceptions of the democratic functioning in their families. European Psychologist, 16, 32–42. doi:10.1027/1016-9040/a000039.

    Article  Google Scholar 

  • Stattin, H., Enebrink, H., Özdemir, M., & Giannotta, F. (2015). A national evaluation of parenting programs in Sweden: the short-term effects using an RCT effectiveness design. Journal of Consulting and Clinical Psychology, 83, 1069–1084. doi:10.1037/a0039328.

    Article  PubMed  Google Scholar 

  • Swanson, J. M. (1992). School-based assessments and interventions for ADD students. Irvine, CA: KC Publishing.

    Google Scholar 

  • Webster-Stratton, C. (1981). Videotape modeling: a method of parent education. Journal of Clinical Child & Adolescent Psychology, 10, 93–98.

    Article  Google Scholar 

  • Webster-Stratton, C. (1984). Randomized trial of two parent-training programs for families with conduct-disordered children. Journal of Consulting and Clinical Psychology, 52, 666–678. doi:10.1037/0022-006x.52.4.666.

    Article  PubMed  Google Scholar 

  • Webster-Stratton, C. (1998). Preventing conduct problems in head start children: strengthening parenting competencies. Journal of Consulting and Clinical Psychology, 66, 715–730. doi:10.1037/0022-006X.66.5.715.

    Article  PubMed  Google Scholar 

  • Webster-Stratton, C., Reid, M. J., & Hammond, M. (2004). Treating children with early-onset conduct problems: intervention outcomes for parent, child, and teacher training. Journal of Clinical Child and Adolescent Psychology, 33, 105–124. doi:10.1207/s15374424jccp3301_11.

    Article  PubMed  Google Scholar 

  • Webster-Stratton, C., Rinaldi, J., & Reid, J. M. (2011). Long-term outcomes of incredible years parenting program: predictors of adolescent adjustment. Child and Adolescent Mental Health, 16, 38–46. doi:10.1111/j.1475-3588.2010.00576.x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wolchik, S. A., Sandler, I. N., Millsap, R. E., Plummer, B. A., Greene, S. M., Anderson, E. R., et al. (2002). Six-year follow-up of preventive interventions for children of divorce: a randomized controlled trial. Journal of the American Medical Association, 288, 1874–1881. doi:10.1001/jama.288.15.1874.

    Article  PubMed  Google Scholar 

  • Zubrick, S. R., Ward, K. A., Silburn, S. R., Lawrence, D., Williams, A. A., Blair, E., et al. (2005). Prevention of child behavior problems through universal implementation of a group behavioral family intervention. Prevention Science, 6, 287–304. doi:10.1007/s11121-005-0013-2.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank the National Board of Health and Welfare in Sweden who funded this trial and we would also like to express our deepest gratitude to the families, care units and group leaders that participated in the study.

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Authors and Affiliations

  1. Department of Clinical Neuroscience, Karolinska Institute, 171 77, Stockholm, Sweden

    Jens Högström & Pia Enebrink

  2. School of Law, Psychology and Social Work, Örebro University, 702 81, Örebro, Sweden

    Viveca Olofsson, Metin Özdemir & Håkan Stattin

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  1. Jens Högström
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  2. Viveca Olofsson
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  4. Pia Enebrink
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  5. Håkan Stattin
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Correspondence to Jens Högström.

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Funding

This study was funded by the National Board of Health and Welfare (Socialstyrelsen) in Sweden, grant number 01–12,042/2008.

Conflict of Interest

Author Jens Högström declares that he has no conflict of interest. Author Viveca Olofsson declares that she has no conflict of interest. Author Metin Özdemir declares that he has no conflict of interest. Author Pia Enebrink declares that she has no conflict of interest. Author Håkan Stattin declares that he has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Supplementary material 1 Means and standard deviations of all outcome measures (DOCX 26 kb)

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Supplementary material 2 Correlations among study variables at baseline (DOCX 17 kb)

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Högström, J., Olofsson, V., Özdemir, M. et al. Two-Year Findings from a National Effectiveness Trial: Effectiveness of Behavioral and Non-Behavioral Parenting Programs. J Abnorm Child Psychol 45, 527–542 (2017). https://doi.org/10.1007/s10802-016-0178-0

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