The purposes of this review were to: (a) outline the literature on negative treatment outcomes of behavioral parent training programs, (b) detail variables found to be predictive of negative treatment outcomes, and (c) suggest future directions of study. We suggest that despite scores of studies documenting positive outcomes of behavioral parent training programs, negative treatment outcomes occur for a sizeable minority of families. Existing research has documented a relationship between a number of contextual stressors and negative outcomes. More research is necessary before the knowledge of the current literature can be applied to clinical practice. Suggestions for needed research are given, including determining which contextual life stressors play a critical role in the relationship, assessing the effect of contextual stressors on various treatments, and determining how contextual life stressors impact the treatment process.
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