Commentary: Empirically Validated Treatments and Child Clinical Interventions

This commentary argues that empirically validated treatments for child and youth behaviour and emotional difficulties are available, but they are relatively inaccessible to the vast majority of Australian children and their families. There are many children who have identifiable problems or who are at increased risk for psychosocial problems whose needs have not been adequately addressed by either the research or the professional community. These incluse children in rural and remote areas, Aboriginal and Torres Strait Islander children, children of migrants, and children with chronic physical illnesses. A comprehensive, preventively focused clinical science of prevention is needed to improve the reach and impact of psychological services for children

Triple P-positive parenting program as a public health approach to strengthening parenting

Parenting programs have considerable potential to improve the mental health and well-being of children, improve family relationships, and benefit the community at large. However, traditional clinical models of service delivery reach relatively few parents. A public health approach is needed to ensure that more parents benefit and that a societal-level impact is achieved. The Triple P-Positive Parenting Program is a comprehensive, multilevel system of parenting intervention that combines within a single intervention universal and more targeted interventions for high-risk children and their parents. With Triple P, the overarching goal is to enhance the knowledge, skills, and confidence of parents at a whole-of-population level and, in turn, to reduce the prevalence rates of behavioral and emotional problems in children and adolescents. The distinguishing features of the intervention and variables that influence its effective implementation are discussed. Self-regulation is a unifying concept that is applied throughout the entire system (e.g., to interactions between children, parents, service providers, and agencies involved in delivering the intervention). Challenges and future directions for the development of public health approaches to parenting are discussed. (PsycINFO Database Record (c) 2009 APA, all rights reserved

Self-administered behavioural family intervention for parents of toddlers: Effectiveness and dissemination

This study examined the effectiveness of a self-administered behavioural family intervention (BFI) for parents of toddlers, within the context of a regular telephone counselling service provider. Telephone counsellors were trained in the delivery of BFI, and 110 mothers of toddlers completed the intervention. There were significant short-term effects of intervention in terms of child behaviour problems and parenting style, parenting confidence and anger. In addition, there were improvements in mother's personal adjustment, and lower levels of parenting conflict. The intervention effects were maintained at 3-month follow-up. The results provide support for the effectiveness of self-administered BFI, and have implications for the population level delivery of behavioural family interventions. (c) 2006 Elsevier Ltd. All rights reserved

The Need for Effective Early Behavioral Family Interventions for Children with Attention Deficit Hyperactivity Disorder (ADHD)

There is a pressing need for the development of effective early family intervention programs for children showing Attention Deficit Hyperactivity Disorder (ADHD) behaviours with Conduct Disorder (CD) or Oppositional Defiant Disorder (ODD) behaviours. Previous research has indicated that children with ADHD are at risk of developing comorbid CD or ODD behaviours. In addition, it has been shown that ODD or CD behaviours in childhood tend to persist and to have adverse effects on later social adjustment. However, ODD or CD behaviours are not necessary concomitants of ADHD, and it has been demonstrated that behavioural intervention can have both short- and long term beneficial effects for children showing early signs of ODD or CD behaviours. In short term, behavioural family interventions may be able to reduce oppositional behaviour, particularly in the preschool years. In the long term, early intervention has shown to reduce the incidence of later antisocial behaviour in children at risk for this developmental trajectory. In this paper, it will be argued that behavioural family interventions have not been effectively utilised or promulgated in the community for children with ADHD despite the demonstrated efficacy of these types of interventions. A model of a multilevel system of intervention that can be tailored to the individual family’s needs is presented

Preliminary Evaluation of the Group Teen Triple P Program for Parents of Teenagers Making the Transition to High School

Group Teen Triple P is a brief group parenting program for parents of teenagers. It is based on the successful Triple P – Positive Parenting Program for parents of children aged from 0 to 12, with a focus on helping parents manage the transition from late childhood to early adolescence. This paper describes the initial evaluation of a universal trial of the program offered to all parents of students entering their first year of high school at age 12 in a regional north Queensland school. Twenty-seven parents completed a battery of self-report questionnaires immediately before and after participating in the 8-week program. Participating parents reported significant reductions in conflict with their teenager, and on measures of laxness, over-reactivity, and disagreements with their partner over parenting issues. These are well-established parenting risk factors. In addition, parents reported significant improvements on measures of self-regulation, including self-efficacy, selfsufficiency, and self-management, and reductions on measures of depression, anxiety, and stress. It was concluded that a preliminary evaluation of the Group Teen Triple P program achieved its goals of reducing targeted risk factors associated with the development of behavioural and emotional problems in teenagers. The paper concludes with an examination of issues around parent recruitment and engagement which are crucial for the successful provision of effective and timely advice and support for parents of teenagers

The Transition to School Project: Results from the Classroom

Conduct problems in children are common, and are associated with significant costs to the family, schools, and society at large. Behavioural Family Intervention (BFI), which targets family interactions, is known to be one of the most effective interventions for the management of child behaviour problems. The school environment is an important aspect of a child’s life, and the degree to which parenting interventions impact on the children’s classroom behaviour has not been adequately assessed. The present research aimed to evaluate the effectiveness of a parenting intervention, namely The Positive Parenting Program – Triple P, in reducing child behaviour problems in the classroom. Year One teachers at 25 state primary schools in Brisbane completed a standardised teacher report measure of child behaviour on all children in their classrooms (n=495 children in control schools, n=490 children at intervention schools). Compared to control schools, the levels of teacher reported conduct problems were significantly lower in the intervention schools. The results of this study provide evidence that a parent training program such as Triple P can be effective in reducing the impact of child behaviour problems in the classroom

Towards a public health approach to parenting

There are various parenting, school and personal factors at play in determining a child’s risk of developing serious conduct problems. The temptation is therefore to conclude that “more is better than less”, but we think that has not been convincingly demonstrated. Some large-scale multi-risk-factor reduction approaches that include parenting, school and child-specific interventions with older school-aged children have shown promise but are complex to administer, costly to implement and have yet to show strong long-term outcomes. But in young children (toddler and preschool-aged children) there is strong evidence that social-learning-based parenting programmes are effective with a wide range of families from quite diverse socio-economic and ethnic backgrounds. We choose to focus on such programmes

Adopting a population-level approach to parenting and family support intervention

Evidence-based treatments and preventive interventions in the child and family area have not met with widespread adoption by practitioners. Despite the high prevalence of child behavioral and emotional problems, many parents and families in need are not receiving or participating in services, and when they do, the most efficacious interventions are not what is usually provided. Simultaneously addressing the issues of low penetration and insufficient dissemination of evidence-based programming requires a population approach to parenting and family support and intervention. Process issues are important, particularly in relation to engagement of stakeholders, recruitment of practitioners, consideration of organizational factors, and use of media and communication strategies. This article discusses why there is a need for a population-based approach, provides a framework of how to conceptualize such an approach, and describes an example from our own work of a recently initiated prevention trial that illustrates a population-based approach in action. The rationale, structure, and goals of the Triple P System Population Trial are described in the context of the aforementioned population framework. (C) 2007 Elsevier Ltd. All rights reserved

Designing effective behavioral family interventions for stepfamilies

There is growing evidence that children living in stepfamilies are at greater risk of developing behavior problems, particularly aggressive, antisocial behavior problems, than children living in intact two-parent families. These children are also at high risk of serious long-term consequences including school drop-out and substance abuse. Despite the existence of an effective technology for treating behaviorally disturbed children within traditional family contexts, no research has examined the efficacy of intervention programs designed for children with behavior problems living in stepfamilies. This article reviews the stepfamily research literature to identify factors contributing to child behavior problems in the remarried family context. An integrated model of the development and maintenance of child behavior problems in stepfamilies is developed. Key areas relevant to the treatment of problems in the stepfamily context are discussed. A behavioral family intervention addressing the skills deficits identified in the model is outlined. The implications for the design of stepfamily interventions and issues relevant to conducting effective therapy are highlighted. There is a clear need for future research in this area. In particular, it is recommended that controlled trials be conducted of interventions that specifically address factors known to contribute to child behavior problems in stepfamilies, and which use state of the art behavioral family intervention techniques

X-ray observations of the galaxy cluster PKS 0745-191: To the virial radius, and beyond

We measure X-ray emission from the outskirts of the cluster of galaxies PKS 0745-191 with Suzaku, determining radial profiles of density, temperature, entropy, gas fraction, and mass. These measurements extend beyond the virial radius for the first time, providing new information about cluster assembly and the diffuse intracluster medium out to ~1.5 r_200, (r_200 ~ 1.7 Mpc ~ 15'). The temperature is found to decrease by roughly 70 per cent from 0.3-1 r_200. We also see a flattening of the entropy profile near the virial radius and consider the implications this has for the assumption of hydrostatic equilibrium when deriving mass estimates. We place these observations in the context of simulations and analytical models to develop a better understanding of non-gravitational physics in the outskirts of the cluster.Comment: 10 pages, 11 figures, accepted to MNRAS; expanded discussion of analysis and uncertainties, results qualitatively unchange