Father participation in behavioral parent training for ADHD: Review and recommendations for increasing inclusion and engagement.

Research on parenting has generally focused on mothers, with fathers' parenting approaches and interventions for fathers being relatively less studied. To investigate the involvement of fathers in behavioral parent training (BPT), the literature on BPT for attention-deficit/hyperactivity disorder (ADHD) was reviewed. A systematic review of this literature (N = 32) indicated that the majority of research studies are composed of mothers as participants in treatment and raters of outcome (87% of reviewed studies did not include information on father-related outcomes). Present barriers to father participation in BPT (e.g., content of classes, characteristics of fathers) are discussed. Strategies for increasing father participation are offered and include establishing the expectation that fathers will be involved in treatment at initial clinical contacts, collecting treatment-related information from both parents, conducting BPT classes that focus on issues of direct relevance to fathers, and integrating parent-child interactions in recreational settings into BPT programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in caregiver depression in response to parent training: Genetic moderation of intervention effects.

A previous report in the Journal of Family Psychology (S. R. H. Beach et al., 2008) described the results of a randomized prevention trial contrasting families who participated in the Strong African American Families Program (SAAF, a preventive intervention for rural African American parents and their 11-year-olds) with control families. This brief report examines a novel contextual variable, child's genetic risk status for negative affect and poor self-control, as a moderator of treatment effects on caregiver's depression. Genetic data were obtained from (N = 109) youths' saliva samples. The primary study hypothesis of differential program impact on caregiver depression as a function of youth genetic risk was confirmed. Among caregivers with initially elevated scores on the Center for Epidemiologic Studies--Depression Scale (L. S. Radloff, 1977), SAAF participation was associated with greater impact on depressive symptoms among those whose children were at genetic risk, suggesting that effect size estimates based on full samples may underestimate the impact of prevention programs on at-risk subgroups, whose response is particularly important to understand and to target. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pretreatment social relations, therapeutic alliance, and improvements in parenting practices in parent management training.

The authors examined the parent-therapist alliance in parent management training for children (N = 218; 53 girls and 165 boys, ages 2-14) referred clinically for oppositional, aggressive, and antisocial behavior. The interrelations of pretreatment parent social relationships, the parent-therapist alliance over the course of treatment, and improvements in parenting practices at the end of treatment were evaluated by different raters. As expected, the better the quality of the parent-therapist alliance, the greater the improvements in parenting practices by the end of treatment. Social relations of the parents prior to treatment were associated with the parent-therapist alliance during treatment and parental improvements at the end of treatment. The relation between the therapeutic alliance and improvement in parenting practices was partially explained by pretreatment parent social relations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How attendance and quality of participation affect treatment response to parent management training.

This study examined whether attendance and quality of participation in parent management training predicted treatment response. Data were from 445 parents (55% minority, 62% single; almost all of low socioeconomic status) who had 1st-grade children with severe conduct problems. Quality of participation in weekly parent groups was based on group leader ratings. Parent outcomes were based on interviewer ratings, behavioral observations, parent reports, and teacher ratings. Results of hierarchical linear models suggested that few family characteristics predicted attendance in this efficacy trial and that attendance was not related to changes in parenting over the year. However, several family characteristics predicted quality of participation in parent management training, and this in turn predicted changes in parental perceptions, warmth, physical punishment, and school involvement. From a clinical perspective, these findings suggest that it is not enough to get parents to attend sessions; it is also necessary to facilitate their active engagement in the therapeutic process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment effectiveness of parent management training in Norway: A randomized controlled trial of children with conduct problems.

This study was a randomized control trial (RCT) of Parent Management Training--The Oregon Model (PMTO) in Norway. A sample representing all health regions of Norway and consisting of 112 children with conduct problems and their families participated in the study. Families were randomly assigned to either PMTO or a regular services comparison group. PMTO was delivered via existing children's services, and families were recruited using the agencies' regular referral procedures, making this the first effectiveness study of PMTO and the first RCT of PMTO conducted outside of the United States. Using a multiagent-multimethod approach, results showed that PMTO was effective in reducing parent-reported child externalizing problems, improving teacher-reported social competence, and enhancing parental discipline. Age level and gender modified the effects of PMTO treatment on other outcomes. In a path model, participation in PMTO was associated with improved parental discipline, and effective discipline predicted greater child compliance, fewer child-initiated negative chains, and lower levels of child externalizing problems. Findings are presented along with a discussion of the implications for practice and research and the challenges accompanying effectiveness trials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized controlled trial of a brief intervention for increasing participation in parent management training.

Evidence-based treatments exist for a range of child and adolescent behavior problems; however, effects are often limited by poor treatment attendance and adherence. The authors developed and evaluated the efficacy of a brief (5 to 45 min) intervention designed to increase treatment attendance and adherence in a sample of 76 parents referred for treatment of their child's oppositional, aggressive, and antisocial behavior. The results of this randomized controlled trial showed that parents who received this brief intervention had greater treatment motivation, attended significantly more treatment sessions, and had greater adherence to treatment according to both parent and therapist report. This study provides researchers and clinicians with a brief and efficacious method of increasing motivation, attendance, and adherence for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing problems with boys' noncompliance: Effects of a parent training intervention for divorcing mothers.

This study provided a randomized, experimental test of the efficacy of a parent training intervention on coercive discipline, positive parenting practices, and child noncompliance in a sample of 238 divorcing mothers and their sons in Grades 1–3. Intervention effects were evaluated 5 times from baseline to 30 months. The intervention produced enduring benefits to coercive discipline, positive parenting, and boys' noncompliance. These benefits followed a classic prevention effect: Mothers and sons in the experimental group maintained stable outcome trajectories, whereas those in the control group deteriorated. The intervention's impact on boys' noncompliance was mediated independently by its impact on coercive discipline and positive parenting. Change in positive parenting was more strongly associated with change in noncompliance than was change in coercive discipline, although each explained unique variance in change in noncompliance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relapse prevention training and problem-solving therapy in the long-term management of obesity.

This study compared 2 extended therapy programs for weight management with standard behavioral treatment (BT) without additional therapy contacts. Participants were 80 obese women who completed 20 weekly group sessions of BT and achieved a mean initial weight loss of 8.74 kg. Participants were randomly assigned to a no-further-contact condition (BT only) or to one of two extended interventions consisting of relapse prevention training (RPT) or problem-solving therapy (PST). No significant overall weight-change differences were observed between RPT and BT or between RPT and PST. However, participants who completed the PST intervention had significantly greater long-term weight reductions than BT participants, and a significantly larger percentage of PST participants achieved clinically significant losses of 10% or more in body weight than did BT participants (35% vs 6%). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of problem-solving communication training alone, behavior management training alone, and their combination for parent–adolescent conflict in teenagers with ADHD and ODD.

Two family therapies were compared using teens with attention-deficit/hyperactivity disorder. Ninety-seven families were assigned to either 18 sessions of problem-solving communication training (PSCT) alone or behavior management training (BMT) for 9 sessions followed by PSCT for 9 sessions (BMT/PSCT). Both treatments demonstrated significant improvement in ratings of parent-teen conflicts at the midpoint but did not differ. By posttreatment, both produced improvement on ratings and observations but did not differ. Significantly more families dropped out of PSCT alone than out of BMT/PSCT. At most, 23% of families showed reliable change either by midpoint or by posttreatment, with no differences between therapies. Yet 31–70% of families were normalized. Group-level change and normalization rates support treatment efficacy, whereas indices of reliable change are less impressive. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of feedback on insight and problem solving efficiency in training groups.

"An experiment was conducted in a field setting to investigate two of the learning principles utilized in human relations courses. The Ss were 103 first line supervisors, in groups of about 12, in a one week, highly participative management course… . The data indicated that personalized feedback markedly, and consistently, improved group problem solving efficiency. Under some conditions, feedback improved self-insight." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects and generalizability of communally oriented HIV-AIDS prevention versus general health promotion groups for single, inner-city women in urban clinics.

A primary prevention, behavioral intervention designed to reduce HIV risk behavior was tested in a randomized, controlled trial with single, inner-city women. A total of 935 women were randomly assigned to 1 of 3 conditions: a small group, 6-session communally oriented HIV prevention intervention; a yoked general health promotion intervention control; or a standard care control. Both interventions involved the interactive use of videotapes by live group leaders. The HIV prevention intervention, in particular, resulted in significant positive effects on self-reported and behaviorally assessed safer-sex behavior. Women in the HIV prevention group showed reduced point prevalences of medically tested sexually transmitted diseases at follow-up in some comparisons. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teaching self-care to caregivers: Effects of mindfulness-based stress reduction on the mental health of therapists in training.

Preparation for the role of therapist can occur on both professional and personal levels. Research has found that therapists are at risk for occupationally related psychological problems. It follows that self-care may be a useful complement to the professional training of future therapists. The present study examined the effects of one approach to self-care, Mindfulness-Based Stress Reduction (MBSR), for therapists in training. Using a prospective, cohort-controlled design, the study found participants in the MBSR program reported significant declines in stress, negative affect, rumination, state and trait anxiety, and significant increases in positive affect and self-compassion. Further, MBSR participation was associated with increases in mindfulness, and this enhancement was related to several of the beneficial effects of MBSR participation. Discussion highlights the potential for future research addressing the mental health needs of therapists and therapist trainees. (PsycINFO Database Record (c) 2010 APA, all rights reserved)