Fathers make important and unique contributions to positive child development. In spite of these findings, the research literature has lagged in the study of the role and impact of fathers on child development and in the development of effective approaches and interventions for fathers. Parameters for additional study include the inclusion of fathers in treatment outcome studies, the engagement of fathers within studies once included, the retention of fathers in interventions and studies once engaged, and the appropriate measurement of father-related outcomes. A systematic review of 64 studies indicated that there is evidence that fathers have been included within multiple studies aimed at improving parenting but that there are relatively fewer studies of other targeted outcomes such as coparenting. A set of recommendations for future directions in the next generation of father-focused studies in the child and adolescent psychology literature is presented, with an emphasis on improving study of the parameters of inclusion, engagement, retention, and measurement of outcomes.
Objective: As pediatric behavioral health concerns are increasingly identified and addressed within pediatric primary care and family medicine practices, behavioral health providers (BHPs) in integrated primary care (IPC) are often faced with not only addressing the psychosocial needs of their child patients, but also confronting the needs of those patients' caregivers. Given the extensive body of evidence demonstrating that child mental health is associated with caregiver mental health, continued discussions of addressing caregiver mental health within the integrated care context are warranted. Method: The current paper will discuss obstacles to establishing family-centered comprehensive behavioral care including ethical concerns around informed consent, scope of practice, and dual relations, and various practice considerations. Results: The obstacles are greater for establishing family-centered comprehensive behavioral care within pediatric settings compared to family practice settings due to the additional practice considerations. The potential benefit to children and the broader family system may warrant the effort. Conclusions: By identifying and discussing these issues, BHPs working within pediatric and family medicine settings are encouraged to engage in active dialogue with hospital and clinic administrators to overcome systemic barriers and to think flexibly about how BHPs might expand upon existing approaches in order to utilize the IPC opportunity to address parent mental health concerns that may otherwise impede a child's treatment progress.
Implications for Impact StatementTreating adult caregivers within pediatric primary or family care settings has the potential of vastly improving the mental health of the entire family. Integrated pediatric primary care provides an ideal setting for behavioral health providers to provide holistic family care. To do this effectively, ethical and practical barriers must be discussed and dismantled.
Behavioral skills training (BST) is an effective modality to train parents in a variety of behavioral techniques for their children. However, extended wait times for behavioral health services can result in increased severity of children's problem behaviors. Furthermore, there is limited research demonstrating that behavior management techniques trained via BST generalizes beyond the setting in which they were trained. The purpose of this study was to evaluate the effectiveness of group‐based BST to improve three caregivers' use of effective instruction delivery (EID) for three children diagnosed with neurodevelopmental disorders and determine the extent to which effective instructions maintained and generalized to the home. Results indicated that all three caregivers' improved their EDI which resulted in children's improved response to instructions that maintained over time. Furthermore, caregivers' use of EID generalized to the home and maintained over time. Findings, implications, and areas for future research are discussed.
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