Parental and Familial Predictors and Moderators of Parent Management Treatment Programs for Conduct Problems in Youth

Abstract

Despite the established efficacy of Parent Management Training (PMT) for conduct problems in youth, evidence suggests that up to half of all treated youth still display clinical levels of disruptive behavior post-treatment. The reasons for these unsatisfactory outcomes are poorly understood. The aim of the present review was to provide an updated analysis of studies from the past 15 years that examined parental and familial predictors and moderators of improvement in PMT for conduct problems. A systematic literature review of indicated prevention (children with conduct problem symptoms) and intervention (children with clinical diagnoses) studies published between 2004 and 2019 was conducted. This 15-year time period was examined since the last systematic reviews were reported in 2006 and summarized studies completed through mid-2004 (see Lundahl, Risser, & Lovejoy, 2006, and Reyno & McGrath, 2006). Risk of bias indices was also computed (see Higgins, Savović, Page, & Stern, 2016) in our review. A total of 21 studies met inclusion criteria. Results indicated that a positive parent-child relationship was most strongly associated with better outcomes; however, little additional consistency in findings was evident. Future PMT research should routinely examine predictors and moderators that are both conceptually and empirically associated with treatment outcomes. This would further our understanding of factors that are associated with poorer treatment outcome and inform the development of treatment components or modes of delivery that might likely enhance evidence-based treatments and our clinical science. Protocol Registration Number: PROSPERO CRD42017058996.

Understanding Differential Effectiveness of Behavioral Parent Training from a Family Systems Perspective: Families Are Greater than “Some of Their Parts”

“…Indeed, parents who experienced high levels of stress were more likely to complete the program (Rostad et al, 2018) and showed stronger decreases in harsh discipline after participation (Pereira et al, 2014). Moreover, stronger effects of BPT on disruptive child behavior were found in families with a history of drug abuse (Beauchaine et al, 2005) or maternal depression (Leijten et al, 2020, but for conflicting results see Dedousis‐Wallace et al, 2021).…”

“…However, to our knowledge the caregiver–child relationship has seldom been tested as a moderator of BPT effectiveness. A recent review found three studies that have measured different aspects of the caregiver‐child relationship in the context of BPT, with mixed results (Dedousis‐Wallace et al, 2021). For example, caregiver‐reported dysfunction in the caregiver‐child relation predicted BPT effects, where children of reporting lower levels of parent–child dysfunction showed a larger decrease in disruptive behavior (Lavigne et al, 2008).…”

The ecology of youth psychological wellbeing in the COVID-19 pandemic.

“…Of course, parenting interventions are not a panacea. Even with therapist-conducted interventions, more than 33% of young people with conduct problem behaviour do not substantially improve ( Dedousis-Wallace, Drysdale, McAloon, & Ollendick, 2021 ), and approximately 40% of young people with anxiety disorders do not respond to treatment ( Creswell, Waite, & Hudson, 2020 ). Importantly, very few children receive any evidence-based treatments, underscoring again the critical importance of developing more readily accessible approaches ( Creswell, Waite, & Hudson, 2020 ).…”

The Incredible Years Parenting and Child Treatment Programs: A Randomized Controlled Trial in a Child Welfare Setting in Spain

“…We hypothesized that IY-Parent and IY-Child programs will be effective in improving parenting skills, reducing child behavior problems, and consequently reducing the risk of child abuse. Also, IY effects on related variables such as parenting stress and parents' psychological distress were explored because, although they have been identified as relevant risk factors for child maltreatment (Barnhart & Maguire-Jack, 2016;Schaeffer et al, 2005;Stith et al, 2009), evidence about the effects of parenting programs on such variables is mixed, with some studies showing such effects (Barlow et al, 2014;Berliner et al, 2015;Furlong et al, 2012;Hutchings et al, 2007Hutchings et al, , 2012Pinquart & Teubert, 2010;Weber et al, 2019) and others failing to confirm them (Chen & Chan, 2016;Dedousis-Wallace et al, 2021;Leijten et al, 2017). Finally, we explored whether post-intervention changes were maintained after the intervention ended, and the influence of family sociodemographic characteristics, parent participation in the program (couple vs. only one parent), and program attendance on intervention effects.…”