The Effectiveness of Parent Management Training—Oregon Model in Clinically Referred Children with Externalizing Behavior Problems in The Netherlands

Abstract

The present study examined the effectiveness of parent management training—Oregon model (PMTO) as a treatment for children with externalizing behavior problems in The Netherlands. Clinically referred children (N = 146) aged 4–11 years and their parents were partly randomized to either PMTO (n = 91) or Care As Usual (CAU; n = 55). Families were assessed at four time points: at pretreatment, and after 6, 12, and 18 months. Results showed that both PMTO and CAU were effective in reducing child externalizing behavior, parenting stress and parental psychopathology, with no significant differences between the two treatment conditions. PMTO and CAU interventions also produced some improvements in self-reported parenting skills, but not in observed parenting skills. According to the Reliable Change Index, 16.9 and 45.8 % of the children within the PMTO group showed full recovery or improvement in externalizing behavior, respectively, versus 9.7 and 42.8 % in the CAU condition. Finally, the effect size of PMTO on parent-reported externalizing behavior problems as found in the present study was comparable to that found in previous studies evaluating PMTO as an intervention for this type of child psychopathology.

Treatment Fidelity during Therapist Initial Training is related to Subsequent Effectiveness of Parent Management Training—Oregon Model

“…Only those measures were used for which the effectiveness study revealed significant effects of PMTO (see Thijssen et al 2017). Treatment effects were operationalized in terms of difference scores and calculated for each assessment instrument: scores at baseline (T0) were subtracted from scores at 6 (T1), 12 (T2), and 18 (T3) months.…”

“…In previous studies, PMTO has been shown to produce positive effects on child externalizing behavior outcomes and parenting practices, and this appears not only true in the United States where the program was developed (e.g., Forgatch and DeGarmo 1999 ; Forgatch et al 2009 ), but also in other countries such as Norway, Iceland, and The Netherlands (Ogden and Amlund-Hagen 2008 ; Sigmarsdóttir et al 2014 ; Thijssen et al 2017 ). However, the effectiveness of PMTO depends on the therapists’ treatment fidelity.…”

“…The present study relies on the data collected for a study evaluating the effectiveness of PMTO in The Netherlands (Thijssen et al 2017 ). In this study, only certified PMTO therapists were involved, which implies that all therapists had at least a sufficient FIMP score.…”

Moderators Influencing the Effectiveness of a Behavioral Teacher Program

“…Susceptibility to behavioral treatments could also depend on severity of a child’s problem behavior at baseline. Superior treatment effects are found for children with more severe behavioral problems compared to children with less severe symptomology ( Lundahl et al, 2006 ; Reyno and McGrath, 2006 ; Lavigne et al, 2008 ; Kolko et al, 2011 ; Thijssen et al, 2017 ; Leijten et al, 2018 ), although other studies report worse treatment effects for children with more severe behavioral problems ( Owens et al, 2003 ; Van Lier et al, 2004 ). More room for improvement would explain why larger effects were observed for children with more severe problem behavior.…”

“…Regarding demographic characteristics, the moderating effects of age and gender are worth investigating given the age-dependent decline of ADHD symptoms and conduct problems ( Lahey et al, 2000 ; Faraone et al, 2006 ) and gender-specific manifestation of problem behavior, with less externalizing and more internalizing problems in girls than in boys ( Gershon and Gershon, 2002 ). Regarding age, results are inconsistent, with some (meta-analytic) evidence suggesting that older children might profit more from (parent-based) behavioral programs ( van den Hoofdakker et al, 2010 ; Comer et al, 2013 ) and other (meta-analytic) evidence indicating no moderating effect of age ( Beauchaine et al, 2005 ; Lundahl et al, 2006 ; Enebrink et al, 2012 ; Thijssen et al, 2017 ). With regard to gender, results are also inconclusive.…”