Parenting intervention programs
All three articles today address interventions to assist parents. First, Sanchez, Javadi & Comer (2024) published “Family Engagement in a Behavioral Parenting Intervention: A randomized comparison of telehealth versus office-based treatment formats” in Journal of Consulting and Clinical Psychology. Here’s the edited abstract and impact staements:
Despite effective treatment options, many families—especially those from marginalized backgrounds—lack access to quality care for their children’s behavioral difficulties. Since the COVID-19 pandemic, telehealth has become a prominent format for the delivery of outpatient services, with potential to increase access to quality care. Although telehealth-delivered parenting interventions are associated with positive clinical outcomes, limited research has examined whether telehealth formats improve treatment engagement relative to office-based care. The present study is the first controlled comparison of engagement across office-based parent–child interaction therapy (PCIT) and internet-delivered PCIT (iPCIT). Children ages 3–5 years, and their caregiver(s) (N = 40) participated in a randomized trial comparing iPCIT to office-based PCIT in the treatment of behavioral problems. Analyses examined the effects of treatment format on engagement (i.e., missed sessions, premature treatment discontinuation, homework completion, therapeutic alliance, and treatment satisfaction). Logistic and linear regressions further explored whether treatment format moderated the effects of common predictors of treatment engagement (i.e., family economic means, racial/ethnic background, caregiver stress). iPCIT improved attendance rates relative to office-based PCIT, especially for families from minoritized racial/ethnic backgrounds. At the same time, among families with relatively higher levels of caregiver stress, office-based PCIT was associated with lower dropout rates and improved treatment alliance and satisfaction, relative to iPCIT. This study provides the first experimental support that telehealth formats can improve treatment attendance in behavioral parenting interventions. Findings highlight nuances in treatment engagement across treatment formats that reveal limits to the extent telehealth transcends engagement concerns.
This study provides the first controlled trial supporting the potential for telehealth to improve session attendance in a behavioral parenting intervention, especially for racially or ethnically minoritized individuals. This study also demonstrated that there are nuances in whether telehealth or office-based services are preferred for improving engagement in mental health treatment.
Though it’s a small sample, I found this helpful both in identifying the value of telehealth and suggesting the circumstances in which office-based care is preferable. The next study looks at a different intervention. Melendez-Torres et al. (2024) published “Disruptive Child Behavior Severity and Parenting Program Session Attendance: Individual participant data meta-analysis” in Journal of Consulting and Clinical Psychology. Here’s the edited abstract:
We tested if baseline disruptive child behavior problem severity predicts parental attendance at sessions of a parenting group program. We used a database of randomized trials of the Incredible Years parenting program in Europe and restricted the sample to participants randomized to the intervention arm. Using baseline Eyberg Child Behavior Inventory scores, we distinguished between trial-level problem severity and child-level problem severity, compared linear and quadratic functional forms at both levels, and considered cross-level interactions, all in a multilevel Poisson regression framework. Drawing on 918 participants in 12 trials, we found that within trials, parents of children with the least and most severe problems attended fewer sessions. Between trials, each additional 10-point increase in the Eyberg Child Behavior Inventory trial mean predicted an 11% increase in attendance. Models including child sex, age, or family low-income did not change coefficients or their interpretation. Our findings suggest that although generally attendance is higher in parents of children with more challenging behavior, it seems difficult for group programs to keep families with the least or most severe problems engaged. Our findings call for the need to better understand the conditions under which lower attendance translates into equivalent or lesser program benefits.
This is a much larger sample. I was not surprised by the findings but saw it as helpful to know that the challenge of keeping parents engaged is when their children have either low or high problem severity. The final study also looks at a specific intervention. Hails et al. (2024) published “Parenting Self-Efficacy in Relation to the Family Check-up’s Effect on Elementary School Children’s Behavior” in Journal of Family Psychology. The edited abstract follows:
Prior research points to the promotion of parenting self-efficacy (PSE) as an important component of parenting interventions; however, few studies have tested PSE as a mediator or moderator of the effects of parenting programs on child behavior. In the present study, we examined the efficacy of the family check-up (FCU), a brief, strengths-based parenting intervention adapted for kindergarten school entry. We tested the FCU’s effects on reducing growth in parent-reported child conduct problems (CP) from kindergarten to fifth grade and whether PSE functioned as a mediator or moderator of intervention effects, using a latent growth curve model and intent-to-treat approach. Participants were parents of 321 children from five elementary schools in a northwestern U.S. city. Although we did not find a main effect of the FCU in reducing growth in CP from kindergarten through fifth grade, we found a significant indirect effect of the FCU on reducing CP growth via improving PSE in second grade and that the indirect effect was moderated by baseline levels of PSE. Together, our findings suggest that the FCU is effective in promoting PSE, which is subsequently associated with reduced CP growth, particularly for parents with initially low PSE. Our findings bolster existing work on the relationship between PSE and child CP in the context of a preventive parenting intervention and emphasize the importance of PSE as an agent of change.
I like the idea of the family check-up and the findings seem quite promising. Helping parents be better parents is always difficult and we know that the earlier we can intervene the better for parents and children.