Training Students to do In-Home Behavioral Therapy with Toddlers from Low-Income Families

The purpose of this project was to develop an internship training program that offered in-home therapy for young children with significant emotional and behavior problems. The children lived in single-parent, low-income homes in unsafe neighborhoods of a large, urban area. A year-long, training and supervision program was implemented with ten second-year, graduate students enrolled in five different university programs that prepared mental health professionals. Students received specialized instruction in working with diverse families living in poverty and in an evidence-based treatment program. They initially observed veteran counselors implementing the treatment program in homes and gradually assumed responsibility for conducting sessions on their own. Students’ scores on a measure of counseling self-efficacy improved significantly from pre- to post-internship. Students reported high levels of satisfaction with the training program and significantly improved confidence levels in their counseling skills at the conclusion of their internship experience. The limitations of these preliminary outcomes for this pilot program are discussed along with the need for more research in this understudied area

Home-Based Therapy for Young Children in Low-Income Families: A Student Training Program

The purpose of this project was to develop an internship training program that offered in-home therapy for young children with significant emotional and behavior problems. The children lived in single-parent, low-income homes in unsafe neighborhoods of a large, urban area. A year-long, training and supervision program was implemented with 10 second-year, graduate students enrolled in 5 different university programs that prepared mental health professionals. Students received specialized instruction in working with diverse families living in poverty and in an evidence-based treatment program. They initially observed veteran counselors implementing the treatment program in homes and gradually assumed responsibility for conducting sessions on their own. Students’ scores on a measure of counseling self-efficacy improved significantly from pre-to post-internship. Students reported high levels of satisfaction with the training program and significantly improved confidence levels in their counseling skills at the conclusion of their internship experience. The limitations of these preliminary outcomes for this pilot program are discussed along with the need for more research in this understudied area

Parent Attributional Style And Early Termination From Child And Parent Therapy

ABSTRACT PARENT ATTRIBUTIONAL STYLE AND EARLY TERMINATION FROM CHILD AND PARENT THERAPY Ryan J. Mattek, M.A. Marquette University, 2013 Behavior problems are prevalent in young children and represent a threat to a child\u27s typical development. These early behavior problems are even more common in children from low-income, urban settings. If left untreated, such challenging behaviors may become ingrained and lead to later more severe behaviors including aggression, violence, and anti-social behaviors. Research has demonstrated that participation in child and parent therapy (CPT) programs significantly reduces problematic child behaviors while increasing positive behaviors in both the child and the parent. However, CPT programs report rates of early termination as high as 70%. Research to reduce these early termination rates have historically focused on barriers to treatment including logistical conflicts, race, culture, socioeconomic status, child age, and symptom severity. However, several years of implementing intervention enhancements specifically designed to address these barriers have yielded only moderate and inconsistent results and early termination rates in CPT programs have remained essentially unchanged. More recent research has focused on a new category of barriers to treatment, parent cognitive variables. One such cognitive variable is parental attributions - the spontaneous explanations that parents make to explain the reason for their child\u27s behaviors. This study examined whether attributional style can predict treatment compliance in a CPT program specifically targeting low-income, urban, minority parents of children with behavior problems. For the study, 425 parents of children with behavior problems completed the Parent Cognition Scale - Adapted (PCS-A) to assess their parent-referent and child-referent attributions at pretest and posttest. Results indicated that parents of children with behavior problems tended to have a more negative attributional style at pretest, but that these attributions underwent a positive shift after receiving CPT treatment. Results also indicated that caregivers who viewed themselves as more of the cause of their child\u27s behavior problems at pretest were significantly more likely to successfully complete the CPT program. Alternatively, caregivers who viewed their child as more responsible for their own behavior problems at pretest were significantly more likely to prematurely terminate from the CPT program. Limitations of the study, suggestions for future research, and implications for CPT programs serving similar populations were discussed

Evaluation of a University-Community Partnership to Provide Home-Based, Mental Health Services for Children from Families Living in Poverty

A university-community partnership is described that resulted in the development of community-based mental health services for young children from families living in poverty. The purpose of this pilot project was to implement an evidence-based treatment program in the homes of an at-risk population of children with significant emotional and behavior problems that were further complicated by developmental delays. Outcomes for 237 children who participated in the clinic’s treatment program over a 2 year period are presented. Comparisons are included between treatment completers and non-completers and the issues of subject attrition, potential subject selection bias, and the generalizability of the results are addressed. The need for more professionals who are trained to address mental health issues in very young children who live in very challenging conditions are discussed

Predicting Treatment Success in Child and Parent Therapy Among Families in Poverty

Behavior problems are prevalent in young children and those living in poverty are at increased risk for stable, high-intensity behavioral problems. Research has demonstrated that participation in child and parent therapy (CPT) programs significantly reduces problematic child behaviors while increasing positive behaviors. However, CPT programs, particularly those implemented with low-income populations, frequently report high rates of attrition (over 50%). Parental attributional style has shown some promise as a contributing factor to treatment attendance and termination in previous research. The authors examined if parental attributional style could predict treatment success in a CPT program, specifically targeting low-income urban children with behavior problems. A hierarchical logistic regression was used with a sample of 425 families to assess if parent- and child-referent attributions variables predicted treatment success over and above demographic variables and symptom severity. Parent-referent attributions, child-referent attributions, and child symptom severity were found to be significant predictors of treatment success. Results indicated that caregivers who viewed themselves as a contributing factor for their child\u27s behavior problems were significantly more likely to demonstrate treatment success. Alternatively, caregivers who viewed their child as more responsible for their own behavior problems were less likely to demonstrate treatment success. Additionally, more severe behavior problems were also predictive of treatment success. Clinical and research implications of these results are discussed

Behavior Problems in Toddlers With and Without Developmental Delays: Comparison of Treatment Outcomes

The purpose of this study is to examine the effectiveness of an in-home parent management program for toddlers with behavior problems and developmental delays by comparing outcomes for a group of toddlers with developmental delays (n = 27) and a group of toddlers without developmental delays (n = 27). The majority of children lived in single parent, low-income homes. Results suggest that the parent management program is equally effective for children with and without developmental delays. Parents from both groups reported clinically significant improvement in their children\u27s behavior and parenting practices. Clinical implications regarding the importance of these findings for improving outcomes for toddlers with behavior problems and developmental delays living in poverty were discussed