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Klein CC, Salem H, Becker-Haimes EM, Barnett ML. Therapist Anxious Distress and Avoidance of Implementing Time-Out. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01706-1. [PMID: 38819665 DOI: 10.1007/s10578-024-01706-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 06/01/2024]
Abstract
Therapist anxious distress when delivering child mental health treatment has been understudied as a factor that contributes to the underuse of some evidence-based interventions (EBIs), such as time-out for children with disruptive behaviors. This study investigated therapist anxious avoidance of time-out using a three-part, vignette-based survey design. Therapists (n = 198) read a vignette of an in-session time-out and reported on their personal anxious distress and likelihood of discontinuing the implementation of time-out. Therapists also provided open-ended descriptions of challenges to delivering time-out. Therapists reported moderate anxious distress at time points 1 and 2 and lower anxious distress at time 3 when the time-out had resolved. Most therapists endorsed some avoidance of time-out. Binomial logistic regression analyses indicated that increased anxious distress corresponded with an increased probability of avoiding time-out delivery in the future. Qualitative reports expanded on challenges to implementing time-out. Findings suggest the importance of addressing therapist anxious distress when implementing children's mental health treatments.
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Affiliation(s)
- Corinna C Klein
- Department of Counseling, Clinical, & School Psychology, University of California, Santa Barbara, Santa Barbara, CA, USA.
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Hanan Salem
- Department of Counseling, Clinical, & School Psychology, University of California, Santa Barbara, Santa Barbara, CA, USA
| | - Emily M Becker-Haimes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Miya L Barnett
- Department of Counseling, Clinical, & School Psychology, University of California, Santa Barbara, Santa Barbara, CA, USA
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2
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Pellecchia M, Mandell DS, Beidas RS, Dunst CJ, Tomczuk L, Newman J, Zeigler L, Stahmer AC. Parent Coaching in Early Intervention for Autism Spectrum Disorder: A Brief Report. JOURNAL OF EARLY INTERVENTION 2023; 45:185-197. [PMID: 37655268 PMCID: PMC10469633 DOI: 10.1177/10538151221095860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Coaching caregivers of young children on the autism spectrum is a critical component of parent-mediated interventions. Little information is available about how providers implement parent coaching for children on the autism spectrum in publicly funded early intervention systems. This study evaluated providers' use of parent coaching in an early intervention system. Twenty-five early intervention sessions were coded for fidelity to established caregiver coaching techniques. We found low use of coaching techniques overall, with significant variability in use of coaching across providers. When providers did coach caregivers, they used only a few coaching strategies (e.g., collaboration and in-vivo feedback). Results indicate that targeted training and implementation strategies focused on individual coaching components, instead of coaching more broadly, may be needed to improve the use of individual coaching strategies. A focus on strengthening the use of collaboration and in-vivo feedback may be key to improving coaching fidelity overall.
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Affiliation(s)
- Melanie Pellecchia
- Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania
| | - David S. Mandell
- Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania
| | - Rinad S. Beidas
- Departments of Psychiatry, Medical Ethics and Health Policy, & Medicine; Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI); Center for Health Incentives and Behavioral Economics (CHIBE);Perelman School of Medicine, University of Pennsylvania
| | | | - Liza Tomczuk
- Center for Mental Health, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania
| | - Jeannette Newman
- Philadelphia Infant and Toddler Early Intervention, Department of Behavioral Health and Intellectual DisAbility Services
| | - Lisa Zeigler
- Philadelphia Infant and Toddler Early Intervention, Department of Behavioral Health and Intellectual DisAbility Services
| | - Aubyn C. Stahmer
- Department of Psychiatry and Behavioral Sciences, University of California Davis
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3
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Huber LT, Molthen F, Cook G, Hughes-Belding K. Facilitating caregiver-child interactions in home visiting: A qualitative observational study. Infant Ment Health J 2023. [PMID: 37256727 DOI: 10.1002/imhj.22063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 06/02/2023]
Abstract
Facilitating parent-child interactions is a key component of evidence-based early childhood home visiting programs. Several observational measures have been created to effectively capture home visiting activities from an operationalized perspective. While the field has a reasonable understanding of what home visitors can do to facilitate developmentally supportive interactions, and why, the how remains elusive for many home visitors. This qualitative study used a modified grounded theory approach to examine the facilitation of caregiver-child interactions during home visits. Home visit video recordings previously coded using the Home Visit Rating Scale (HOVRS) A+ were selected based on facilitation quality. Sixteen home visits (8 lower- and 8 higher-quality facilitation scores) were examined for differences in home visitor behaviors that support parent-child interactions during visits. We identified contextual and specific behaviors that home visitors used to actively engage caregivers and children together in developmentally supportive interactions. Results revealed 11 home visitor behaviors that discriminated higher quality facilitation. These behaviors were categorized into four domains: environmental conditions, executing the activity, strengths-based focus, and caregiver responses. This qualitative study highlights specific behaviors and professional development areas to support more effective home visiting services for a diverse population of families with young children.
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Affiliation(s)
| | | | - Gina Cook
- California State University, Stanislaus, Turlock, California, USA
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4
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Ghaffari A, Azad A, Zarei MA, Rassafiani M, Sharif Nia H. Efficacy of Occupational Performance Coaching with and without Four Quadrant Model of Facilitated Learning for mothers of children with specific learning disorder: Study protocol for a randomized controlled trial. Contemp Clin Trials Commun 2022; 30:101009. [PMID: 36186541 PMCID: PMC9523350 DOI: 10.1016/j.conctc.2022.101009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/27/2022] [Accepted: 09/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background In addition to academic problems, children with a specific learning disability (SLD) encounter problems with participation in activities outside school. Purpose To investigate the efficacy of Occupational Performance Coaching (OPC) with and without Four Quadrant Model of Facilitated Learning (4QM) in the mothers of children with SLD. Method A single-blinded, parallel-group randomized clinical trial will be carried out. Mothers of children with SLD will constitute the participants and be allocated to experimental (OPC+4QM) and control (OPC alone) groups. Key issues Children's occupational performance and satisfaction, participation in activities outside school, goals attainment, executive function, and academic achievement along with self-efficacy of mothers will be measured in baseline, post-intervention, and one-month follow-up stages. Implications An OPC intervention protocol may improve children's participation in activities outside school and may help clarify whether 4QM promotes maternal empowerment and better results for children with SLD. Trial registration Clinical Trials, IRCT20140416017301N9. (https://en.irct.ir/trial/55842)
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Affiliation(s)
- Amin Ghaffari
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mehdi Alizadeh Zarei
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mehdi Rassafiani
- School of Allied Health, Exercise and Sports Sciences, Charles Sturt University, Albury, Australia
| | - Hamid Sharif Nia
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences (MUMS), Sari, Iran
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5
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Agazzi H, Soca Lozano S, Hernandez M. Low Treatment Fidelity as an Indication to Switch Interventions: Pivoting From Child-Parent Psychotherapy to Parent-Child Interaction Therapy for Early Childhood Trauma. Clin Case Stud 2022. [DOI: 10.1177/15346501221124980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Young children who experience trauma and adverse experiences are at an increased risk of developing an insecure attachment style as well as negative physical and mental health problems. These can include internalizing and externalizing behavioral problems, developmental delay, emotional dysregulation, and aggression. Several evidence-based interventions exist to treat young children with symptoms related to trauma, each with different foundational theories. This article presents the case of a 4-year-old boy with posttraumatic stress disorder who was in the middle of a legal fight between caregivers and transitioning between caregivers’ homes. Initially, therapy began with Child-Parent Psychotherapy to address caregivers’ first concerns. Later, the therapeutical approach was switched to Parent-Child Interaction Therapy due to difficulty with treatment fidelity related to caregivers’ symptoms and conflict. This case demonstrates great improvement in treatment fidelity and subsequently problem behaviors after switching to an intervention that allowed to address behavior management shortcomings in a family with ongoing conflict.
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Affiliation(s)
- Heather Agazzi
- Departments of Pediatrics and Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | | | - Michael Hernandez
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida Health, Tampa, FL, USA
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6
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Niec LN, Brodd I, Schoonover CE. Searching for the Standard: The Impact of Level of Training on In Vivo Coaching in Parent-Child Interaction Therapy. Behav Modif 2022; 47:93-112. [PMID: 35674406 DOI: 10.1177/01454455221099647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although live coaching using behavioral principles is a powerful mechanism of change in behavioral parent training (BPT), little research has examined the coaching process. We used a cross-sectional sample of coaches with different levels of training in the evidence-based behavioral parent training model parent-child interaction therapy (PCIT) to begin to understand how training impacts coaching techniques. Forty-six coaches including PCIT lay helpers, therapists, within-agency and global/regional trainers, provided a sample of coaching in response to a standardized parent-child interaction. Level of training was significantly and positively associated with coaching verbalizations (r(44) = .80, p < .001). Training level was also associated with effective coaching strategies such that as training increased, coaches used more strategies related to positive treatment outcomes for families. Results suggest that coaches with less training may benefit from additional education around certain types of responsive coaching strategies. Findings raise important questions about how "adequate" and "optimal" coaching might be defined.
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Affiliation(s)
| | - Irene Brodd
- Central Michigan University, Mount Pleasant, USA
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7
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Skowron EA, Funderburk BW. In vivo social regulation of high-risk parenting: A conceptual model of Parent-Child Interaction Therapy for child maltreatment prevention. CHILDREN AND YOUTH SERVICES REVIEW 2022; 136:106391. [PMID: 35221407 PMCID: PMC8881007 DOI: 10.1016/j.childyouth.2022.106391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Meta-analyses show that Parent-Child Interaction Therapy (PCIT) significantly reduces child abuse and neglect in families where maltreatment has already occurred; however, research into the underlying mechanisms of change (i.e., how PCIT effects positive changes in parenting) remains limited. In this article, we discuss a new conceptual model of PCIT's active ingredients that is informed by biobehavioral research documenting the physiological underpinnings of problematic parenting. We describe deficits in self-regulation observed in child maltreating parents and PCIT's unique live coaching approach and associated techniques that may form the basis for in-vivo social regulation in the act of parenting that supports more effective, positive parenting behavior, strengthens parents' self-regulation skills, and reduces child maltreatment.
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Affiliation(s)
- Elizabeth A Skowron
- Department of Psychology & Center for Translational Neuroscience, University of Oregon
| | - Beverly W Funderburk
- Department of Developmental and Behavioral Pediatrics, University of Oklahoma Health Sciences Center
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8
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Woodfield MJ, Brodd I, Hetrick SE. Time-Out with Young Children: A Parent-Child Interaction Therapy (PCIT) Practitioner Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:145. [PMID: 35010403 PMCID: PMC8750921 DOI: 10.3390/ijerph19010145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 01/15/2023]
Abstract
Time-out is a component of many evidence-based parent training programmes for the treatment of childhood conduct problems. Existing comprehensive reviews suggest that time-out is both safe and effective when used predictably, infrequently, calmly and as one component of a collection of parenting strategies-i.e., when utilised in the manner advocated by most parent training programmes. However, this research evidence has been largely oriented towards the academic community and is often in conflict with the widespread misinformation about time-out within communities of parents, and within groups of treatment practitioners. This dissonance has the potential to undermine the dissemination and implementation of an effective suite of treatments for common and disabling childhood conditions. The parent-practitioner relationship is integral to the success of Parent-Child Interaction Therapy (PCIT), an evidence-based treatment which involves live coaching of parent(s) with their young child(ren). Yet this relationship, and practitioner perspectives, attitudes and values as they relate to time-out, are often overlooked. This practitioner review explores the dynamics of the parent-practitioner relationship as they apply to the teaching and coaching of time-out to parents. It also acknowledges factors within the clinical setting that impact on time-out's use, such as the views of administrators and professional colleagues. The paper is oriented toward practitioners of PCIT but is of relevance to all providers of parent training interventions for young children.
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Affiliation(s)
- Melanie J. Woodfield
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland 1023, New Zealand;
- Auckland District Health Board, Auckland 1023, New Zealand
| | - Irene Brodd
- Centre for Children, Families and Communities, Department of Psychology, Central Michigan University, Mount Pleasant, MI 48859, USA;
| | - Sarah E. Hetrick
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland 1023, New Zealand;
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3010, Australia
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9
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Preas EJ, Mathews TL. Evaluation of Caregiver Training Procedures to Teach Activities of Daily Living Skills. Behav Anal Pract 2021; 14:958-973. [PMID: 34868809 DOI: 10.1007/s40617-020-00513-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 10/20/2022] Open
Abstract
Caregivers of children with an autism spectrum disorder are often responsible for assisting their children to complete activities of daily living skills. Effective and efficient caregiver training methods are needed to train caregivers. The present study used two concurrent multiple-baseline across-participants designs to evaluate the effects of real-time feedback and behavioral skills training on training eight caregivers to implement teaching procedures for activities of daily living skills with their child. We assessed caregivers' accuracy and correct implementation of the six-component teaching procedure after they received either real-time feedback or behavioral skills training. Caregivers from both groups mastered and maintained correct implementation of the teaching procedures with their child. The overall results suggest that real-time feedback and behavioral skills training are efficacious to train caregivers to implement activities of daily living skills procedures with their children, and that real-time feedback may be an efficient alternative method to train caregivers. Supplementary Information The online version contains supplementary material available at 10.1007/s40617-020-00513-z.
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Affiliation(s)
- Elizabeth J Preas
- Integrated Center for Autism Spectrum Disorders, Munroe-Meyer Institute, University of Nebraska Medical Center, 9012 Q St, Omaha, NE 68127 USA
| | - Therese L Mathews
- College of Nursing, Munroe-Meyer Institute, University of Nebraska Medical Center, Omaha, NE USA
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10
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Noell G, Gansle K, Gulley V. The Impact of Integrated Support and Context on Treatment Implementation and Child Outcomes Following Behavioral Consultation. Behav Modif 2021; 46:1383-1405. [PMID: 34711071 DOI: 10.1177/01454455211054020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Assuring treatment plan implementation following consultation is critically important because implementation is strongly related to outcomes. Treatment implementation has been hypothesized to be influenced by both the nature of the follow-up support provided and contextual variables. However, studies to date have not examined both issues while directly measuring implementation. This study examined treatment implementation following consultation for 48 teachers in public schools who had referred a student for intervention services in a randomized clinical field trial. Participating teachers in the experimental group received Integrated Support (IS). IS includes social influence, planning, and performance feedback elements. IS was compared to weekly follow-up meetings alone. Treatment implementation and child outcomes were markedly superior for IS as compared to weekly follow-up. Three school climate factors were found to be correlated with treatment implementation for the IS group, but not the weekly follow-up group. Participants rated treatment implementation, treatment acceptability, and consultant effectiveness positively and similarly across conditions. The implications of these findings for future work examining school culture, consultation and intervention are discussed.
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Affiliation(s)
| | | | - Veronica Gulley
- Louisiana State University and A&M College, Baton Rouge, USA
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11
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Garcia D, Rodríguez GM, Lorenzo NE, Coto J, Blizzard A, Farias A, Smith NDW, Kuluz J, Bagner DM. Intensive Parent-Child Interaction Therapy for Children with Traumatic Brain Injury: Feasibility Study. J Pediatr Psychol 2021; 46:844-855. [PMID: 34015114 DOI: 10.1093/jpepsy/jsab040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 02/23/2021] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study examined the feasibility and initial outcome of a time-limited and intensive format of Parent-Child Interaction Therapy (PCIT) for families of young children who have sustained a traumatic brain injury (TBI). METHODS The nonrandomized open trial included 15 families with a child aged 2-5 years who had sustained a TBI and displayed clinically elevated levels of externalizing behavior problems. Families received clinic-based PCIT twice per week over an average of 6 weeks, with the exception of two families that received the same intensity and format of PCIT in the home. RESULTS Ten of the 14 families who completed the baseline assessment (71%) completed the intervention and post and follow-up assessments. On average, caregivers completed homework practice on 52% of the days in between sessions. Caregivers reported high acceptability and satisfaction following the intervention, as well as decreases in child externalizing and internalizing behavior problems at the post-assessment and 2-month follow-up. CONCLUSIONS Results of this open trial provide preliminary support for the feasibility of a time-limited and intensive format of PCIT for families of young children who have sustained a TBI and have elevated levels of behavior problems. This study highlights a promising intervention approach for improving domains commonly affected by early childhood TBI and preventing the development of more severe and persistent problems.
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Affiliation(s)
- Dainelys Garcia
- Department of Pediatrics, Miller School of Medicine, University of Miami
| | | | | | - Jennifer Coto
- Department of Pediatrics, Miller School of Medicine, University of Miami
| | - Angela Blizzard
- Department of Pediatrics, Miller School of Medicine, University of Miami
| | - Alina Farias
- College of Psychology, Nova Southeastern University
| | | | - John Kuluz
- Department of Pediatric Neurosurgery, Nicklaus Children's Hospital
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12
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Cepni AB, Taylor A, Crumbley C, Thompson D, Moran NE, Olvera N, O’Connor DP, Arlinghaus KR, Johnston CA, Ledoux TA. Feasibility and Efficacy of the "FUNPALs Playgroup" Intervention to Improve Toddler Dietary and Activity Behaviors: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157828. [PMID: 34360118 PMCID: PMC8345510 DOI: 10.3390/ijerph18157828] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/14/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022]
Abstract
This study evaluated the feasibility and effects of the Families Understanding Nutrition and Physically Active Lifestyles (FUNPALs) Playgroup on toddler (12–36-month-old) diet and activity behaviors. Parent–toddler dyads were recruited from disadvantaged communities and randomly assigned to receive 10-weekly sessions of the FUNPALs Playgroup (n = 24) or dose-matched health education control group (n = 26). FUNPALs Playgroups involved physical and snack activities, delivery of health information, and positive parenting coaching. The control group involved group health education for parents only. Process outcomes (e.g., retention rate, fidelity) and focus groups determined feasibility and perceived effects. To evaluate preliminary effects, validated measures of toddler diet (food frequency questionnaire and a carotenoid biomarker), physical activity (PA; accelerometers), general and feeding parenting (self-report surveys), and home environment (phone interview) were collected pre and post. The sample comprised parents (84% female) who self-identified as Hispanic/Latino (38%) and/or African American (32%). Retention was high (78%). Parents from both groups enjoyed the program and perceived improvements in their children’s health behaviors. Objective measures demonstrated improvement with large effects (η2 = 0.29) in toddler diet (p < 0.001) but not PA (p = 0.099). In conclusion, the FUNPALs Playgroup is feasible and may improve toddler eating behaviors.
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Affiliation(s)
- Aliye B. Cepni
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA; (A.B.C.); (C.C.); (D.P.O.); (C.A.J.)
| | - Ashley Taylor
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX 77204, USA;
| | - Christine Crumbley
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA; (A.B.C.); (C.C.); (D.P.O.); (C.A.J.)
| | - Debbe Thompson
- USDA/ARS Children’s Nutrition Research Center and Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (D.T.); (N.E.M.)
| | - Nancy E. Moran
- USDA/ARS Children’s Nutrition Research Center and Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; (D.T.); (N.E.M.)
| | - Norma Olvera
- Department of Psychological, Latino Health Disparities Lab, University of Houston, Houston, TX 77204, USA;
| | - Daniel P. O’Connor
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA; (A.B.C.); (C.C.); (D.P.O.); (C.A.J.)
| | - Katherine R. Arlinghaus
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55455, USA;
| | - Craig A. Johnston
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA; (A.B.C.); (C.C.); (D.P.O.); (C.A.J.)
| | - Tracey A. Ledoux
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA; (A.B.C.); (C.C.); (D.P.O.); (C.A.J.)
- Correspondence: ; Tel.: +1-713-743-1870
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13
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Breitenstein SM, Fehrenbacher C, Holod AF, Schoeny ME. A Randomized Trial of Digitally Delivered, Self-Administered Parent Training in Primary Care: Effects on Parenting and Child Behavior. J Pediatr 2021; 231:207-214.e4. [PMID: 33338496 PMCID: PMC9272894 DOI: 10.1016/j.jpeds.2020.12.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 12/04/2020] [Accepted: 12/09/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the effects of a self-administered, digital behavioral parent training program on parent and child behavior for parents of young children. STUDY DESIGN A randomized controlled trial compared ezParent (digital delivery of the evidence-based Chicago Parent Program) with an enhanced usual-care control. Introduction to the study occurred during well-child visits at 4 primary care clinics. In total, 287 parents of children age 2-5 years were randomized to ezParent or the control. Parents responded to surveys evaluating parent behavior, self-efficacy, and stress, and child behavior at baseline, and 3-, 6-, and 12-months postbaseline. Multilevel growth models examined parent and child outcomes for intervention efficacy in intent-to-treat analyses. Secondary moderation analysis explored intervention effects by program use and baseline parenting stress and child behavior problems. RESULTS The intervention main effect was not significant for parent and child behaviors. In exploratory moderation analysis, parents in the ezParent condition with greater baseline parenting stress reported less corporal punishment (P = .044); and greater improvement in parental warmth (P = .008), setting limits (P = .026), and proactive parenting (P = .019). Parents reporting greater baseline child behavior problems reported greater improvements in parental warmth (P = .007), setting limits (P = .003), and proactive parenting (P = .010). There were no differences in outcomes based on program usage. CONCLUSIONS Results suggest that ezParent as a self-administered behavioral parent training program may not be intense enough for child and parent behavioral change as a universal prevention model. Parents may require different levels of support for completion based on their level of service seeking, family characteristics, risk profile, and motivation for change. TRIAL REGISTRATION Clinicaltrials.gov: NCT02723916.
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Affiliation(s)
| | | | - Alicia F Holod
- The Ohio State University, College of Nursing, Columbus, OH
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14
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Heymann P, Heflin BH, Bagner DM. Effect of Therapist Coaching Statements on Parenting Skills in a Brief Parenting Intervention for Infants. Behav Modif 2021; 46:691-705. [PMID: 33448233 DOI: 10.1177/0145445520988140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Behavioral parenting interventions have been shown to decrease early childhood behavior problems by improving parenting skills. Few studies have examined the impact of therapist coaching statements on parenting skill acquisition, especially among ethnic minority families and non-English-speaking families. In this study, we examined therapists' use of responsive and directive coaching statements during the first coaching session in a brief parenting intervention, the Infant Behavior Program (IBP), on changes in parenting skill acquisition. Participants were 24 mothers of 12- to 15-month-olds, with elevated levels of behavioral problems from primarily Latinx and low-income backgrounds. Mothers who heard more responsive coaching from their therapist showed greater increases in positive parenting skills. Spanish-speaking therapists used fewer responsive coaching statements and more commands, however, language spoken did not moderate the effect of these statements on changes in parenting skills. Responsive coaching statements in English and Spanish had a positive impact on parenting skill acquisition.
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15
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PCIT-Health: Preventing Childhood Obesity by Strengthening the Parent–Child Relationship. COGNITIVE AND BEHAVIORAL PRACTICE 2020. [DOI: 10.1016/j.cbpra.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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16
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Dell’armi M, Kruck J, Niec L. Prise en charge des troubles du comportement du jeune enfant par le programme Parent-Child Interaction Therapy (PCIT). PRAT PSYCHOL 2020. [DOI: 10.1016/j.prps.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bachmeyer‐Lee MH, Kirkwood CA, Sheehan CM, Gibson AL, Shuler NJ, Keane JA. Utilizing in‐vivo feedback for caregiver training of pediatric feeding protocols. J Appl Behav Anal 2020; 53:1622-1637. [DOI: 10.1002/jaba.693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 11/06/2022]
Affiliation(s)
| | - Caitlin A. Kirkwood
- University of North Carolina Wilmington & Center for Pediatric Behavioral Health
| | - Connor M. Sheehan
- University of North Carolina Wilmington & Center for Pediatric Behavioral Health
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18
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Kohlhoff J, Morgan S, Briggs N, Egan R, Niec L. Parent–Child Interaction Therapy with Toddlers: A Community-based Randomized Controlled Trial with Children Aged 14-24 Months. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2020; 50:411-426. [DOI: 10.1080/15374416.2020.1723599] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jane Kohlhoff
- School of Psychiatry, University of New South Wales
- Research Department, Karitane
| | | | - Nancy Briggs
- Mark Wainwright Analytical Centre, University of New South Wales
| | - Ryan Egan
- University of Oklahoma Health Sciences Center, University of Oklahoma
| | - Larissa Niec
- Center for Children, Families, and Communities, Department of Psychology, Central Michigan University
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19
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Kruythoff-Broekman A, Wiefferink C, Rieffe C, Uilenburg N. Parent-implemented early language intervention programme for late talkers: parental communicative behaviour change and child language outcomes at 3 and 4 years of age. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2019; 54:451-464. [PMID: 30680870 DOI: 10.1111/1460-6984.12451] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/10/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Late language emergence is a risk indicator for developmental language disorder. Parent-implemented early language intervention programmes (parent programmes) have been shown to have positive effects on children's receptive and expressive language skills. However, long-term effectiveness has rarely been studied. Additionally, little is known about which strategies parents learn to use after participating in parent programmes and whether this affects their child's language development. AIMS To evaluate medium- and long-term effectiveness (1 and 2 years after inclusion) of a low-dosage parent programme in a sample of late talkers (LTs) with an expressive language delay. Specifically, we investigated which strategies the parents learned to use in interaction with their child and which strategies were associated with child language growth over time. METHODS & PROCEDURES This quasi-experimental study with a longitudinal design included 24-month-old LTs. After the pre-test, parents of children in the intervention group received a parent programme (n = 30), while parents of children in the comparison group received care as usual (n = 30). Children's language development was assessed using standardized language tests at pre-test and two follow-up tests at 36 and 48 months of age. Change in parental communicative behaviour was measured by a parent-child interaction observation measure, at pre-test and follow-up at 36 months of age. OUTCOMES & RESULTS At 36 months old, children in the parent programme group showed a significantly higher growth in expressive vocabulary than children in the comparison group. However, differences between the groups were not seen in the long-term, at the 48-month follow-up. In contrast to parents in the comparison group, parents in the parent programme group changed their communicative behaviour positively in two domains: Interaction and Pressure on the child. However, no changes in the domains of Language Stimulation and Responsiveness were observed. Children's growth in expressive vocabulary and expressive syntax was associated with a decrease in the domain of Pressure. CONCLUSIONS & IMPLICATIONS At 4 years of age, the majority of children in both groups achieved expressive vocabulary scores within the normal range. However, the mean score for expressive syntax in both groups remained below that of their peers, and 29% of the children still had expressive language scores below the mean range. Ongoing monitoring of LTs' language development is necessary in order to make decisions regarding the timing and nature of intervention.
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Affiliation(s)
| | - Carin Wiefferink
- Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands
| | - Carolien Rieffe
- Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands
- Developmental Psychology Leiden University, Leiden, the Netherlands
| | - Noëlle Uilenburg
- Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands
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20
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Kimonis ER, Fleming G, Briggs N, Brouwer-French L, Frick PJ, Hawes DJ, Bagner DM, Thomas R, Dadds M. Parent-Child Interaction Therapy Adapted for Preschoolers with Callous-Unemotional Traits: An Open Trial Pilot Study. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2018; 48:S347-S361. [DOI: 10.1080/15374416.2018.1479966] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
| | | | - Nancy Briggs
- Mark Wainwright Analytical Centre (Stats Central), The University of New South Wales
| | | | - Paul J. Frick
- Department of Psychology, Louisiana State University
- Learning Sciences Institute of Australia, Australian Catholic University
| | | | | | - Rae Thomas
- Faculty of Health Sciences and Medicine, Bond University
| | - Mark Dadds
- School of Psychology, University of Sydney
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21
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Parent–Child Care as a Brief Dyadic Intervention for Children With Mild to Moderate Externalizing Problems: A Case Study. Clin Case Stud 2018. [DOI: 10.1177/1534650118774417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although many parenting interventions have been shown efficacious in reducing externalizing behavior problems in young children, they often take months to implement and tend to target children with moderate to severe behavior problems. Parent–Child Care (PC-CARE) was designed to be an engaging, brief (six-session) dyadic intervention to reduce mental health symptoms even for children with few behavior problems and/or parents who are unable to commit to lengthy treatments. We present an evidence-based case study of a 5-year-old child with mild externalizing problems and his biological parents, who participated in PC-CARE. Standardized measures were collected, and the child’s and parents’ emotional availability were assessed at pre- and posttreatment. Weekly codings of parent–child interactions and parent-reported measures of child behaviors were also collected. This child’s behavioral symptoms improved from pre- to posttreatment (per parents’ reports and observation), and he maintained this improved behavior 1 month after treatment. The parents similarly demonstrated improvement in their use of parenting skills and emotional availability. Aspects of treatment that may affect effectiveness are discussed.
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22
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Kaehler LA, Jacobs M, Jones DJ. Distilling Common History and Practice Elements to Inform Dissemination: Hanf-Model BPT Programs as an Example. Clin Child Fam Psychol Rev 2018; 19:236-58. [PMID: 27389606 DOI: 10.1007/s10567-016-0210-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is a shift in evidence-based practice toward an understanding of the treatment elements that characterize empirically supported interventions in general and the core components of specific approaches in particular. The evidence base for behavioral parent training (BPT) and the standard of care for early-onset disruptive behavior disorders (oppositional defiant disorder and conduct disorder), which frequently co-occur with attention deficit hyperactivity disorder, are well established, yet an ahistorical, program-specific lens tells little regarding how leaders, University of Oregon Medical School, shaped the common practice elements of contemporary evidence-based BPT. Accordingly, this review summarizes the formative work of Hanf, as well as the core elements, evolution, and extensions of her work, represented in Community Parent Education (COPE; (Cunningham et al. in J Child Psychol Psychiatry 36:1141-1159, 1995; Cunningham et al. in COPE, the community parent education program: large group community-based workshops for parents of 3- to 18-year-olds, COPE Works, Hamilton, 2009), Defiant Children (DC; (Barkley in Defiant children: a clinician's manual for assessment and parent training, Guilford Press, New York, 1987; Barkley in Defiant children: a clinician's manual for assessment and parent training, Guilford Press, New York, 2013), Helping the Noncompliant Child (HNC; Forehand and McMahon in Helping the noncompliant child: a clinician's guide to parent training, Guilford Press, New York, 1981; McMahon and Forehand in Helping the noncompliant child: family-based treatment for oppositional behavior, 2nd ed., Guilford Press, New York, 2003), Parent-child interaction therapy (PCIT; Eyberg and Robinson in J Clin Child Adolesc Psychol 11:130-137, 1982. doi:10.1080/15374418209533076; Eyberg in Child Fam Behav Ther 10:33-46, 1988; Eyberg and Funderburk in Parent-child interaction therapy protocol, PCIT International, Gainesville, 2011), and the Incredible Years (IY; (Webster-Stratton in Behav Ther 12:634-642, 1981. doi:10.1016/S0005-7894(81)80135-9; Webster-Stratton in J Pediatr Psychol 7:279-294, 1982. doi:10.1093/jpepsy/7.3.279; Webster-Stratton in The incredible years: parents and children series. Leader's guide: preschool version of BASIC (ages 3-6 years, The Incredible Years, Seattle, 2008). Our goal is not to provide an exhaustive review of the evidence base for the Hanf-Model programs, rather our intention is to provide a template of sorts from which agencies and clinicians can make informed choices about how and why they are using one program versus another, as well as how to make inform flexible use one program or combination of practice elements across programs, to best meet the needs of child clients and their families. Clinical implications and directions for future work are discussed.
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Affiliation(s)
- Laura A Kaehler
- Children's Advocacy Services of Greater St. Louis, University of Missouri, St. Louis, MO, USA
| | - Mary Jacobs
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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23
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Lieneman CC, Brabson LA, Highlander A, Wallace NM, McNeil CB. Parent-Child Interaction Therapy: current perspectives. Psychol Res Behav Manag 2017; 10:239-256. [PMID: 28790873 PMCID: PMC5530857 DOI: 10.2147/prbm.s91200] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Parent-Child Interaction Therapy (PCIT) is an empirically supported intervention originally developed to treat disruptive behavior problems in children between the ages of 2 and 7 years. Since its creation over 40 years ago, PCIT has been studied internationally with various populations and has been found to be an effective intervention for numerous behavioral and emotional issues. This article summarizes progress in the PCIT literature over the past decade (2006-2017) and outlines future directions for this important work. Recent PCIT research related to treatment effectiveness, treatment components, adaptations for specific populations (age groups, cultural groups, military families, individuals diagnosed with specific disorders, trauma survivors, and the hearing-impaired), format changes (group and home-based), teacher-child interaction training (TCIT), intensive PCIT (I-PCIT), treatment as prevention (for externalizing problems, child maltreatment, and developmental delays), and implementation are discussed.
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Affiliation(s)
- Corey C Lieneman
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Laurel A Brabson
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - April Highlander
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Nancy M Wallace
- Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Cheryl B McNeil
- Department of Psychology, West Virginia University, Morgantown, WV, USA
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24
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In Pursuit of Generalization: An Updated Review. Behav Ther 2016; 47:733-746. [PMID: 27816084 DOI: 10.1016/j.beth.2015.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 10/23/2015] [Accepted: 11/17/2015] [Indexed: 01/03/2023]
Abstract
Stokes and Osnes (1989) outlined three principles to facilitate the generalization and maintenance of therapeutic gains. Use of functional contingencies, training diversely, and incorporating functional mediators were recommended. Our review, with most illustrations from studies of youth, updates Stokes and Osnes's original paper with a focus on evidence-based strategies to increase generalization of therapeutic gains across settings, stimuli, and time. Research since 1989 indicates that training for generalization by increasing the frequency of naturally occurring reinforcers for positive behaviors, and altering maladaptive contingencies that inadvertently reinforce problem behaviors, are associated with favorable treatment outcomes. Training diversely by practicing therapy skills across contexts and in response to varying stimuli is also implicated in clinical outcomes for internalizing, externalizing, and neurodevelopmental disorders. Preliminary research recommends the use of internal (e.g., emotion identification) and external (e.g., coping cards) functional mediators to prompt effective coping in session and at home. Strategies for increasing generalization, including the use of technology, are examined and future research directions are identified.
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25
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Niec LN, Barnett ML, Prewett MS, Shanley Chatham JR. Group parent-child interaction therapy: A randomized control trial for the treatment of conduct problems in young children. J Consult Clin Psychol 2016; 84:682-698. [PMID: 27018531 PMCID: PMC5325686 DOI: 10.1037/a0040218] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of parent-child interaction therapy (PCIT), a treatment for young children with conduct problems. METHOD Eighty-one families with 3- to 6-year-old children (71.6% boys, 85.2% White) with diagnoses of oppositional defiant or conduct disorder were randomized to individual PCIT (n = 42) or the novel format, Group PCIT. Parents completed standardized measures of children's conduct problems, parenting stress, and social support at intake, posttreatment, and 6-month follow-up. Therapist ratings, parent attendance, and homework completion provided measures of treatment adherence. Throughout treatment, parenting skills were assessed using the Dyadic Parent-Child Interaction Coding System. RESULTS Parents in both group and individual PCIT reported significant improvements from intake to posttreatment and follow-up in their children's conduct problems and adaptive functioning, as well as significant decreases in parenting stress. Parents in both treatment conditions also showed significant improvements in their parenting skills. There were no interactions between time and treatment format. Contrary to expectation, parents in Group PCIT did not experience greater social support or treatment adherence. CONCLUSIONS Group PCIT was not inferior to individual PCIT and may be a valuable format to reach more families in need of services. Future work should explore the efficiency and sustainability of Group PCIT in community settings. (PsycINFO Database Record
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Affiliation(s)
- Larissa N Niec
- Center for Children, Families, and Communities, Central Michigan University
| | - Miya L Barnett
- Department of Psychology, University of California, Los Angeles
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26
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Kaehler LA, Jacobs M, Jones DJ. Distilling Common History and Practice Elements to Inform Dissemination: Hanf-Model BPT Programs as an Example. Clin Child Fam Psychol Rev 2016. [PMID: 27389606 DOI: 10.1080/15374418209533076.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
There is a shift in evidence-based practice toward an understanding of the treatment elements that characterize empirically supported interventions in general and the core components of specific approaches in particular. The evidence base for behavioral parent training (BPT) and the standard of care for early-onset disruptive behavior disorders (oppositional defiant disorder and conduct disorder), which frequently co-occur with attention deficit hyperactivity disorder, are well established, yet an ahistorical, program-specific lens tells little regarding how leaders, University of Oregon Medical School, shaped the common practice elements of contemporary evidence-based BPT. Accordingly, this review summarizes the formative work of Hanf, as well as the core elements, evolution, and extensions of her work, represented in Community Parent Education (COPE; (Cunningham et al. in J Child Psychol Psychiatry 36:1141-1159, 1995; Cunningham et al. in COPE, the community parent education program: large group community-based workshops for parents of 3- to 18-year-olds, COPE Works, Hamilton, 2009), Defiant Children (DC; (Barkley in Defiant children: a clinician's manual for assessment and parent training, Guilford Press, New York, 1987; Barkley in Defiant children: a clinician's manual for assessment and parent training, Guilford Press, New York, 2013), Helping the Noncompliant Child (HNC; Forehand and McMahon in Helping the noncompliant child: a clinician's guide to parent training, Guilford Press, New York, 1981; McMahon and Forehand in Helping the noncompliant child: family-based treatment for oppositional behavior, 2nd ed., Guilford Press, New York, 2003), Parent-child interaction therapy (PCIT; Eyberg and Robinson in J Clin Child Adolesc Psychol 11:130-137, 1982. doi:10.1080/15374418209533076; Eyberg in Child Fam Behav Ther 10:33-46, 1988; Eyberg and Funderburk in Parent-child interaction therapy protocol, PCIT International, Gainesville, 2011), and the Incredible Years (IY; (Webster-Stratton in Behav Ther 12:634-642, 1981. doi:10.1016/S0005-7894(81)80135-9; Webster-Stratton in J Pediatr Psychol 7:279-294, 1982. doi:10.1093/jpepsy/7.3.279; Webster-Stratton in The incredible years: parents and children series. Leader's guide: preschool version of BASIC (ages 3-6 years, The Incredible Years, Seattle, 2008). Our goal is not to provide an exhaustive review of the evidence base for the Hanf-Model programs, rather our intention is to provide a template of sorts from which agencies and clinicians can make informed choices about how and why they are using one program versus another, as well as how to make inform flexible use one program or combination of practice elements across programs, to best meet the needs of child clients and their families. Clinical implications and directions for future work are discussed.
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Affiliation(s)
- Laura A Kaehler
- Children's Advocacy Services of Greater St. Louis, University of Missouri, St. Louis, MO, USA
| | - Mary Jacobs
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Deborah J Jones
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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27
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Caron EB, Bernard K, Dozier M. In Vivo Feedback Predicts Parent Behavior Change in the Attachment and Biobehavioral Catch-up Intervention. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 47:S35-S46. [PMID: 27043449 DOI: 10.1080/15374416.2016.1141359] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Understanding mechanisms and active ingredients of intervention is critical to training clinicians, particularly when interventions are transported from laboratories to communities. One promising active ingredient of parenting programs is clinicians' in vivo feedback regarding parent-child interactions. The present study examined whether a form of in vivo feedback, in the moment commenting, predicted treatment retention and parent behavior change when the Attachment and Biobehavioral Catch-up (ABC) intervention was implemented in a community setting. Observational data were collected from 78 parent-child dyads (96% mothers; M age = 29 years; 81% minority; infants' M age = 12 months; 90% minority) across 640 sessions conducted by 9 clinicians (100% female, M age = 39; 67% minority) in Hawaii. Parental behavior was assessed with a semistructured play task before and after intervention. Clinicians' in-the-moment feedback to parents was assessed from intervention session videos. Clinicians' frequency and quality of in-the-moment feedback predicted change in parental intrusiveness and sensitivity at posttreatment. Frequency of in-the-moment feedback also predicted likelihood of retention. Hierarchical linear modeling demonstrated strong support for these associations at the between-clinician level, and limited additional support at the within-clinician (i.e., between-case) level. Thus, a hypothesized active ingredient of treatment, in-the-moment feedback, predicted community-based ABC outcomes. The results complement lab-based evidence to suggest that in vivo feedback may be a mechanism of change in parenting interventions. Helping clinicians to provide frequent, high-quality in vivo feedback may improve parenting program outcomes in community settings.
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Affiliation(s)
- E B Caron
- a Department of Psychological and Brain Sciences , University of Delaware
| | | | - Mary Dozier
- a Department of Psychological and Brain Sciences , University of Delaware
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28
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Barnett ML, Niec LN, Peer SO, Jent JF, Weinstein A, Gisbert P, Simpson G. Successful Therapist-Parent Coaching: How In Vivo Feedback Relates to Parent Engagement in Parent-Child Interaction Therapy. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:895-902. [PMID: 26467101 DOI: 10.1080/15374416.2015.1063428] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although behavioral parent training is considered efficacious treatment for childhood conduct problems, not all families benefit equally from treatment. Some parents take longer to change their behaviors and others ultimately drop out. Understanding how therapist behaviors impact parental engagement is necessary to improve treatment utilization. This study investigated how different techniques of therapist in vivo feedback (i.e., coaching) influenced parent attrition and skill acquisition in parent-child interaction therapy (PCIT). Participants included 51 parent-child dyads who participated in PCIT. Children (age: M = 5.03, SD = 1.65) were predominately minorities (63% White Hispanic, 16% African American or Black). Eight families discontinued treatment prematurely. Therapist coaching techniques during the first session of treatment were coded using the Therapist-Parent Interaction Coding System, and parent behaviors were coded with the Dyadic Parent-Child Interaction Coding System, Third Edition. Parents who received more responsive coaching acquired child-centered parenting skills more quickly. Therapists used fewer responsive techniques and more drills with families who dropped out of treatment. A composite of therapist behaviors accurately predicted treatment completion for 86% of families. Although group membership was correctly classified for the treatment completers, only 1 dropout was accurately predicted. Findings suggest that therapist in vivo feedback techniques may impact parents' success in PCIT and that responsive coaching may be particularly relevant.
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Affiliation(s)
- Miya L Barnett
- a Center for Children, Families and Communities , Central Michigan University
| | - Larissa N Niec
- a Center for Children, Families and Communities , Central Michigan University
| | - Samuel O Peer
- a Center for Children, Families and Communities , Central Michigan University
| | - Jason F Jent
- b University of Miami, Miller School of Medicine
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29
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Budd KS, Garbacz LL, Carter JS. Collaborating with Public School Partners to Implement Teacher–Child Interaction Training (TCIT) as Universal Prevention. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1007/s12310-015-9158-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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30
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Niec LN, Acevedo-Polakovich ID, Abbenante-Honold E, Christian AS, Barnett ML, Aguilar G, Peer SO. Working together to solve disparities: Latina/o parents' contributions to the adaptation of a preventive intervention for childhood conduct problems. Psychol Serv 2015; 11:410-20. [PMID: 25383995 DOI: 10.1037/a0036200] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Left untreated, conduct problems can have significant and long-lasting negative effects on children's development. Despite the existence of many effective interventions, U.S. Latina/o children are less likely to access or receive evidence-based services. Seeking to build the foundation to address these service disparities, the current study used a Community-Based Participatory Research approach to examine U.S. Latina/o parents' perceptions of the need for interventions to prevent childhood disruptive behaviors in their community in general, and of an existing evidence-based intervention-parent-child interaction therapy (PCIT)-in particular. Results suggest that parents recognize a need for prevention resources in their community and value most of the core features of PCIT. Nevertheless, important directions for potential adaptation and expansion of PCIT into a prevention approach were identified. Results point to several goals for future study with the potential to ameliorate the unmet mental health needs experienced by U.S. Latina/o families with young children at risk for developing conduct problems.
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Affiliation(s)
- Larissa N Niec
- Center for Children, Families and Communities, Central Michigan University
| | | | | | | | - Miya L Barnett
- Center for Children, Families and Communities, Central Michigan University
| | | | - Samuel O Peer
- Center for Children, Families and Communities, Central Michigan University
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31
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Lindhiem O, Higa J, Trentacosta CJ, Herschell AD, Kolko DJ. Skill acquisition and utilization during evidence-based psychosocial treatments for childhood disruptive behavior problems: a review and meta-analysis. Clin Child Fam Psychol Rev 2015; 17:41-66. [PMID: 23649324 DOI: 10.1007/s10567-013-0136-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
We review 85 empirical articles published since 2000 that measured the acquisition and/or utilization of parent management skills and/or child cognitive-behavioral skills in the context of an evidence-based treatment (EBT) for childhood behavior problems. Results showed that: (1) there are no standardized measures of skill acquisition or skill utilization that are used across treatments, (2) little is known about predictors, correlates, or outcomes associated with skill acquisition and utilization, and (3) few studies systematically examined techniques to enhance the acquisition and utilization of specific skills. Meta-analytic results from a subset of 68 articles (59 studies) showed an overall treatment-control ES = .31, p < .01 for skill acquisition and ES = .20, p = ns for skill utilization. We recommend that future research focus on the following three areas: (1) development of standardized measures of skill acquisition and utilization from a "common elements" perspective that can used across EBTs; (2) assessment of the predictors, correlates, and outcomes associated with skill acquisition and utilization; and (3) development of innovative interventions to enhance the acquisition and utilization of cognitive-behavioral and parent management skills.
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Affiliation(s)
- Oliver Lindhiem
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA,
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32
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Meade EB, Dozier M, Bernard K. Using video feedback as a tool in training parent coaches: promising results from a single-subject design. Attach Hum Dev 2015; 16:356-70. [PMID: 24972104 DOI: 10.1080/14616734.2014.912488] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The Attachment and Biobehavioral Catch-up (ABC) parenting program focuses on three intervention targets: increasing parental nurturance, increasing parental synchrony, and decreasing parental frightening behavior. Parent coaches are expected to comment "in the moment" when behaviors relevant to these three targets are observed in sessions. Making in the moment comments is a challenging aspect of intervention, and parent coaches have struggled with their fidelity to this critical intervention component. Thus, we developed a system for coding the frequency and quality of comments from video-recorded session clips on a statement-by-statement level. To help parent coaches refine and maintain their skills in making such comments, they are taught to code segments of their own video-recorded sessions, with the expectation that gains would be seen in comments after learning to code. In this paper, we describe the fidelity coding system and present initial results from a year-long, single-subject design examining the effects of video feedback coding for a parent coach who was learning the intervention. We observed an increase in frequency of in the moment comments during the period of video feedback coding, consistent with a training effect.
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Affiliation(s)
- E B Meade
- a Department of Psychology , University of Delaware , Newark , USA
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33
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Acevedo-Polakovich ID, Niec LN, Barnett ML, Bell KM, Aguilar G, Vilca J, Abbenante-Honold ES, Christian AS, Peer SO. Exploring the role of Natural Helpers in efforts to address disparities for children with conduct problems. CHILDREN AND YOUTH SERVICES REVIEW 2014; 40:1-5. [PMID: 24910488 PMCID: PMC4041872 DOI: 10.1016/j.childyouth.2014.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The incorporation of natural helpers into services has been suggested as an innovative strategy to address disparities for historically underserved children with conduct problems. In order to inform incorporation efforts, this study examined the perceptions of natural helpers serving one U.S. Latina/o community regarding need for services for children with conduct problems, their reactions to a specific parent training intervention, and the training and support needed to deliver this intervention successfully. Participants identified a need for culturally-responsive services for children with conduct problems, and felt that parent training would be appropriate for the families they serve. Participants further identified specific training and support that they would require in order to deliver parent training with fidelity and effectiveness. Findings support the suggestion that natural helpers have the potential to address service disparities among Latina/o children with conduct problems. Recommendations from natural helpers should guide the development of culturally-adapted preventive interventions that help address existing service disparities.
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Affiliation(s)
| | - Larissa N Niec
- Central Michigan University Center for Children, Families and Communities
| | - Miya L Barnett
- Central Michigan University Center for Children, Families and Communities
| | | | | | - Jeanette Vilca
- Central Michigan University Center for Children, Families and Communities
| | | | | | - Samuel O Peer
- Central Michigan University Center for Children, Families and Communities
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Assessing the Key to Effective Coaching in Parent-Child Interaction Therapy: The Therapist-Parent Interaction Coding System. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2013; 36:211-223. [PMID: 24839350 DOI: 10.1007/s10862-013-9396-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This paper describes the initial evaluation of the Therapist-Parent Interaction Coding System (TPICS), a measure of in vivo therapist coaching for the evidence-based behavioral parent training intervention, parent-child interaction therapy (PCIT). Sixty-one video-recorded treatment sessions were coded with the TPICS to investigate (1) the variety of coaching techniques PCIT therapists use in the early stage of treatment, (2) whether parent skill-level guides a therapist's coaching style and frequency, and (3) whether coaching mediates changes in parents' skill levels from one session to the next. Results found that the TPICS captured a range of coaching techniques, and that parent skill-level prior to coaching did relate to therapists' use of in vivo feedback. Therapists' responsive coaching (e.g., praise to parents) was a partial mediator of change in parenting behavior from one session to the next for specific child-centered parenting skills; whereas directive coaching (e.g., modeling) did not relate to change. The TPICS demonstrates promise as a measure of coaching during PCIT with good reliability scores and initial evidence of construct validity.
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Travis JK, Brestan-Knight E. A Pilot Study Examining Trainee Treatment Session Fidelity when Parent–Child Interaction Therapy (PCIT) Is Implemented in Community Settings. J Behav Health Serv Res 2013; 40:342-54. [DOI: 10.1007/s11414-013-9326-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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