Treatment of depressed mothers with disruptive children: A controlled evaluation of cognitive behavioral family intervention

This study compared the effects of two forms of behavioral family intervention in reducing mothers' depression and disruptive behavior problems in families with a clinically depressed parent and a child with significant conduct problems. Fortyseven parents were randomly assigned to either a Behavioral Family Intervention (BFI) or to Cognitive Behavioral Family Intervention (CBFI) which integrated cognitive therapy strategies to treat depression and teaching of parenting skills. Both treatments were equally effective in reducing mothers' depression and child disruptive behavior on observational and self-report measures at postintervention. However, at 6-month follow-up more families in CBFI (53%) compared to BFI (13%) experienced concurrent clinically reliable reductions in maternal depression and child disruptive behavior. These findings support the value of CBFI in reducing depression in mothers of children with disruptive behavior problems

Sustained Effects of Incredible Years as a Preventive Intervention in Preschool Children with Conduct Problems

The present study evaluated preventive effects of the Incredible Years program for parents of preschool children who were at risk for a chronic pattern of conduct problems, in the Netherlands. In a matched control design, 72 parents of children with conduct problems received the Incredible Years program. These families (intervention group) were compared with 72 families who received care as usual (control group). Two years after termination of the intervention, it appeared that observed and selfrated parenting skills were significantly improved in the intervention group. Likewise, in this group, observed child conduct problems showed sustained intervention effects. The decrease in observed critical parenting mediated the decrease in observed child conduct problems over time. In addition, it appeared that parental influence increased over time

The Incredible Years Autism Spectrum and Language Delays Parent program: A pragmatic, feasibility randomized controlled trial

Behavior problems in children with autism spectrum disorders (ASD) are common and particularly stressful for parents. This study aimed to examine the feasibility of delivering a parenting program in existing services, and the feasibility of conducting a future large‐scale Randomized Controlled Trial evaluation of the effectiveness of the intervention. Parents of children aged 3–8 years with a diagnosis of ASD, or strongly suspected ASD were eligible to participate. A multicenter, pragmatic, feasibility randomized controlled trial was conducted in four specialist children's services in Wales. Families were randomly assigned to receive the Incredible Years® Autism Spectrum and Language Delays (IY‐ASLD) parent program immediately or to a wait‐list, treatment as usual control condition. IY‐ASLD sessions were delivered once a week for 12 weeks. The primary outcomes related to feasibility (recruitment, retention, fidelity, and acceptability). Preliminary outcome analyses were conducted using covariance models controlling for study site and baseline scores. From October 5 to December 19, 2016, 58 families were randomized, 29 to IY‐ASLD and 29 to control. Three parents did not attend any sessions while 19 (73%) completed the program. Fidelity of delivery was high (88%), as was satisfaction with the program. Fifty‐three (91%) completed the follow‐up measures. All 95% CIs for effect sizes included zero in exploratory outcome analyses. This study supports the feasibility of delivering the IY‐ASLD in existing services with good levels of acceptability and fidelity evident. A larger randomized controlled trial is required to examine the effectiveness of the program. Autism Res 2019. © 2019 International Society for Autism Research, Wiley Periodicals, Inc

Balancing Work and Family: A Controlled Evaluation of the Triple P – Positive Parenting Program as a Work-Site Intervention

Despite a wealth of evidence showing that behavioural family intervention is an effective intervention for parents of children with behavioural and emotional problems, little attention has been given to the relationship between parents functioning at work and their capacity to manage parenting and other home responsibilities. This study evaluated the effects of a group version of the Triple-P Positive Parenting Program (WPTP) designed specifically for delivery in the workplace.Participants were 42 general and academic staff from a major metropolitan university who were reporting difficulties managing home and work responsibilities and behavioural difficulties with their children. Participants were randomly assigned to WPTP, or to a waitlist control (WL) condition.Following intervention, parents in WPTP reported significantly lower levels of disruptive child behaviour, dysfunctional parenting practices, and higher levels of parental self-efficacy in managing both home and work responsibilities, than parents in the WL condition. These short-term improvements were maintained at 4-months follow-up. There were also additional improvements in reported levels of work stress and parental distress at follow-up in the WPTP group compared to post-intervention.Implications for the development of 'family-friendly' work environments and the prevention of child behaviour problems are discussed

Measuring the impact and costs of a universal group based parenting programme : protocol and implementation of a trial

Background Sub-optimal parenting is a common risk factor for a wide range of negative health, social and educational outcomes. Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management. The Family Links Nurturing Programme (FLNP) focuses on family relationships as well as behaviour management and is offered on a universal basis. As a result it may be better placed to improve health and educational outcomes. Developed in the UK voluntary sector, FLNP is popular with practitioners, has impressed policy makers throughout the UK, has been found to be effective in before/after and qualitative studies, but lacks a randomised controlled trial (RCT) evidence base. Methods/Design A multi-centre, investigator blind, randomised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2-4 yrs living in or near to Flying Start/Sure Start areas. Changes in parenting, parent child relations and parent and child wellbeing are assessed with validated measures immediately and at 6 months post intervention. Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life. Attendance and completion rates and fidelity to the FLNP course delivery are assessed. A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families. By the end of May 2010, 287 families have been recruited into the trial across four areas of south Wales. Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial, family concern about video and audio recording, programme facilitator concern about the recording of FLNP sessions for fidelity purposes and delays due to the new UK research governance procedures. Discussion Whilst there are strong theoretical arguments to support universal provision of parenting programmes, few universal programmes have been subjected to randomised controlled trials. In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation designed to provide clear evidence with regard to effectiveness and costs. We describe challenges implementing the protocol and how we are addressing these

The impact of child problem behaviours of children with ASD on parent mental health: The mediating role of acceptance and empowerment

DOI: 10.11771362361311422708Raising a child with an autism spectrum disorder (ASD) has often been associated with higher levels of parenting stress and psychological distress, and a number of studies have examined the role of psychological processes as mediators of the impact of child problem behaviour on parent mental health. The current study examined the relations among child problem behaviour, parent mental health, psychological acceptance, and parent empowerment. Participants included 228 parents of children diagnosed with ASD, 6-21 years of age. As expected, psychological acceptance and empowerment were negatively related to the severity of parent mental health problems. When acceptance and empowerment were compared with each other through a test of multiple mediation, only psychological acceptance emerged as a significant partial mediator of the path between child problem behaviour and parent mental health problems. As child problem behaviour increased, parent psychological acceptance decreased, resulting in an increase in parent mental health problems. These findings suggest that for problems that are chronic and difficult to address, psychological acceptance may be an important factor in coping for parents of young people with ASD, in line with the growing literature on positive coping as compared with problem-focused coping.Ontario Mental Health Foundatio

Parental predictors of children's executive functioning from ages 6 to 10.

According to prominent models of child development, parental factors may contribute to individual differences in children's executive functioning (EF). Here, we examine the relative importance of parents' socio-economic status, mental health, and parenting as predictors of EF development, drawing on a large (n = 1,070) community sample of Norwegian children who received biennial EF assessments from 6 to 10 years of age. We measure EF by means of the Behavior Rating Inventory of Executive Function. We assess parenting through observer ratings of parent-child interactions and parental mental health via the Beck Anxiety Inventory, Beck Depression Inventory, and Hopkins Symptom Checklist. When we adjust for all time-invariant unmeasured confounders, higher parental education predicts superior EF development, whereas harsh parenting forecasts poorer EF development. However, parenting does not mediate the effect of parental education. These results indicate that harsh parenting should be targeted in interventions aimed at improving EF. Statement of contribution What is already known on this subject? Parental factors seem to affect child development of executive functions (EF). Specifically, parental socio-economic status, mental health, and their parenting seem to influence the developmental course of child EF. What does this study add? To what degree the parental influence on EF development is likely to be driven by time-invariant factors, for example, genetics. The relative influence of positive and negative parenting on EF development

Why a Universal Population-Level Approach to the Prevention of Child Abuse is Essential

This paper argues for the importance of adopting a population-level approach to promote more effective parenting and to reduce the risk of child maltreatment. Family-based interventions based on social learning principles have been shown to make a useful contribution in the treatment of child maltreatment. However, typically such programmes have been used to treat parents who have already become involved in the child protection system. We argue that the creation of community-wide support structures to support positive parenting is needed to reduce the prevalence of child maltreatment. Such an approach requires several criteria to be met. These include having knowledge about the prevalence rates for the targeted child outcomes sought, knowledge about the prevalence of various parenting and family risk factors, evidence that changing family risk factors reduces the prevalence of targeted problems, having culturally appropriate, cost-effective, evidence-based interventions available and making these widely accessible

Sustained effectiveness of evidence-based parenting programs after the research trial ends

Despite ample evidence of the efficacy and effectiveness of evidence-based parenting programs (EBPPs) within research-led environments, there is very little evidence of maintenance of effectiveness when programs are delivered as part of regular service provision. The present study examined the effectiveness of EBPPs provided during a period of sustained service-led implementation in comparison to research-led effectiveness evaluation. Data from 3706 parents who received EBPPs during sustained implementation by services were compared to data from 1390 parents who had participated in an earlier researcher-led effectiveness trial of a national roll-out of EBPPs in England. In both phases, parents completed measures of child behavior problems, parenting style and parental mental well-being prior to starting parenting programs (pre-test), at the end of the programs (post) and at 12-months follow up. Results from Generalized Estimating Equations controlling for potential covariates indicated significant improvements in child behavior problems during sustained implementation, similar to the effectiveness phase; significant improvements in parenting style which were larger than the effectiveness phase at 12-month follow up; and significant improvements in parental mental well- being. Our findings demonstrate effective maintenance of gains when EBPPs are provided as part of regular provision across a large sample of English parents. Successful long-term implementation should consider effectiveness of EBPPs across the population, given the large contextual changes that take place between researcher-led evaluations and service take-up. Our findings support the integration of EBPPs in public health approaches to addressing child behavior problems and parent well-being