A controlled evaluation of an enhanced self-directed behavioural family intervention for parents of children with conduct problems in rural and remote areas.

Few studies have examined the impact of parenting interventions for families in rural and isolated areas who have children with conduct problems, where-access to professional services can be difficult. The present investigation compared the effects of three conditions, two levels of self-directed behavioral family intervention: an enhanced self-directed program that combined a self-help program using written materials and a weekly telephone consultation (ESD), a self-help program (SD) and a waitlist control group (WL). At postintervention the ESD group reported significantly lower levels of disruptive behaviour, and lower levels of dysfunctional parenting than the SD and WL controls, and higher levels of consumer satisfaction. At 6 months follow-up the main effects for the ESD group had been maintained. The SD group continued to evidence improvement from postintervention to follow-up such that 65% of children in the ESD condition and 57% of children in the SD condition showed clinical reliable change on measures of disruptive behaviour. Implications of findings and directions for future research are discussed

An Outcome Evaluation of the Implementation of the Triple P – Positive Parenting Program in Hong Kong

The present study evaluated the effectiveness of the Positive Parenting Program (Triple P) with a sample of Chinese parents of children with early onset conduct related problems in Hong Kong. The participants consisted of 91 parents whose children attended maternal and child health centers and child assessment centers for service, and were between three to seven years old. Participants were randomly assigned to the intervention (TP) and a waitlist control group (WL. There was no significant difference in pre-intervention measures between the two groups. However, at post intervention, participants in the TP group reported significantly lower levels of child behavior problems, lower dysfunctional parenting styles, and higher parent sense of competence, compared to the WL group. Implications of these findings for the use of Triple P with families of Chinese descent are discussed

Are parent-reported outcomes for self-directed or telephone-assisted behavioral family intervention enhanced if parents are observed?

The study examined the effects of conducting observations as part of a broader assessment of families participating in behavior family intervention (BFI). It was designed to investigate whether the observations improve intervention outcomes. Families were randomly assigned to different levels of BFI or a waitlist control condition and subsequently randomly assigned to either observation or no-observation conditions. This study demonstrated significant intervention and observation effects. Mothers in more intensive BFI reported more improvement in their child’s behavior and their own parenting. Observed mothers reported lower intensity of child behavior problems and more effective parenting styles. There was also a trend for less anger among mothers who were observed and evidence of an observation-intervention interaction for parental anger, with observed mothers in more intensive intervention reporting less anger compared to those not observed. Implications for clinical and research intervention contexts are discussed

A Novel Adaptation of a Parent-Child Observational Assessment Tool for Appraisals and Coping in Children Exposed to Acute Trauma

Background: Millions of children worldwide are exposed to acute potentially traumatic events (PTEs) annually. Many children and their families experience significant emotional distress and/or functional impairment following PTEs. While current research has begun to highlight a role for early appraisals and coping in promoting or preventing full recovery from PTEs, the exact nature of the relationships among appraisals, coping, and traumatic stress reactions as well as how appraisals and coping behaviors are influenced by the child\u27s environment (e.g., parents) remains unclear; assessment tools that reach beyond self-report are needed to improve this understanding. Objective: The objective of the current study is to describe the newly created Trauma Ambiguous Situations Tool (TAST; i.e., an observational child–parent interview and discussion task that allows assessment of appraisals, coping, and parent–child processes) and to report on initial feasibility and validation of TAST implemented with child–parent dyads in which children were exposed to a PTE. Method: As part of a larger study on the role of biopsychosocial factors in posttraumatic stress reactions, children (aged 8–13) and parents (n=25 child–parent dyads) completed the TAST during the child\u27s hospitalization for injury. Results: Children and parents engaged well with the TAST. The time to administer the TAST was feasible, even in a peri-trauma context. The TAST solicited a wide array of appraisals (threat and neutral) and coping solutions (proactive and avoidant). Forced-choice and open-ended appraisal assessments provided unique information. The parent–child discussion portion of the TAST allowed for direct observation of parent–child processes and demonstrated parental influence on children\u27s appraisals and coping solutions. Conclusions: The TAST is a promising new research tool, which may help to explicate how parents influence their child\u27s developing appraisals and coping solutions following a PTE. More research should examine the relationships of appraisals, coping, and parent–child processes assessed by the TAST with traumatic stress outcomes

Predictors of care-giver stress in families of preschool-aged children with developmental disabilities

Background This study examined the predictors, mediators and moderators of parent stress in families of preschool-aged children with developmental disability. Method One hundred and five mothers of preschool-aged children with developmental disability completed assessment measures addressing the key variables. Results Analyses demonstrated that the difficulty parents experienced in completing specific caregiving tasks, behaviour problems during these caregiving tasks, and level of child disability, respectively, were significant predictors of level of parent stress. In addition, parents’ cognitive appraisal of care-giving responsibilities had a mediating effect on the relationship between the child’s level of disability and parent stress. Mothers’ level of social support had a moderating effect on the relationship between key independent variables and level of parent stress. Conclusions Difficulty of care-giving tasks, difficult child behaviour during care-giving tasks, and level of child disability are the primary factors which contribute to parent stress. Implications of these findings for future research and clinical practice are outlined

Child behavior therapy and family context: Research and clinical practice with maritally distressed families

Clinical experience has led many writers in the field of child behavior therapy to point to marital distress as an important predictor of treatment failure. While further research is needed to clarify the role of marital variables in treatment, there is some evidence that marital distress may be associated with failure to maintain change after treatment, despite a successful immediate posttreatment outcome. It appears that behavioral aprent training can improve parent-child interactions while having no impact on marital conflict and other contextual factors that are associated with parent-child relations. Attempts to assess the role of risk factors such as marital distress, maternal depression and social insularity in treatment have been piecemeal and some recommendations for improving clinical practice and research methodologies are made. Evidence is mounting that providing expanded interventions is associated with improved treatment effects, however all expansions of basic parent training appear to improve teratment ourcome and more specificity of sample selection, measures used and control conditions is needed to make sense of this data. For clinical practice, the integration of marital and child focussed interventions is reviewed. An integrative model is described with specific suggestions for facilitation families' adherence to a broadly focussed family intervention that incorporates marital and child foci

The relationship of interparental conflict and global marital adjustment to aggression, anxiety, and immaturity in aggressive and nonclinic children

Although there is agreement that marital problems are associated either directly or indirectly with particular child behavior problems, there is disagreement about the types of marital conflict associated with these problems and the differential effects on boys and girls in clinic and nonclinic samples. We examined the relationships among mothers' ratings of marital adjustment, parenting disagreements, and three child problem factors (aggression, anxiety, and immaturity) after the child's age and family socioeconomic status were controlled. These relationships were compared with samples of boys and girls (3 to 8 years of age) from clinic and nonclinic populations, revealing that parenting disagreement predicted aggression in all groups and that both marital adjustment and parenting disagreement predicted anxiety in boys. Neither marital variable predicted immaturity. Possible reasons for the results (including methodological limitations of the present data) are discussed

Hyperhidrosis: A Case Study and Theoretical Formulation

A case study is presented of a 20-year-old male who experienced marked increases in body temperature and profuse sweating of the forehead and trunk when in formal social situations. No other physiological nor psychological manifestations of anxiety were admitted to and no situational avoidance was reported. Pretreatment, posttreatment, and follow-up self-report measures and daily self-monitoring of intensity and frequency of sweating were collected to evaluate treatment effects. Treatment was conducted over a period of 20 weeks. Cued conditioning and desensitisation were initially employed, however treatment effect was difficult to determine. The effects of an inadvertent in vivo exposure in week 6 of treatment and the subsequent change in treatment to exposure and cognitive therapy are discussed. The positive effects of treatment, which led to a decrease in the frequency and intensity of the sweating response, were evident at the completion of treatment and well maintained at 60 weeks follow-up. The use of exposure and cognitive therapy as a suitable treatment for this disorder are discussed in light of other anxiety disorders