Therapist-assisted online treatment for child conduct problems in rural and urban families: Two randomized controlled trials.

Abstract

Objective: We examined the relative efficacy of an online versus face-to-face (FTF) parenting intervention for reducing the severity of child conduct problems and related parent and child outcomes in 2 randomized controlled trials. Method: In Study 1, rural families (n ϭ 133) with a child 3-9 years of age with a full or subclinical primary diagnosis of oppositional defiant or conduct disorder traveled to Sydney, Australia for a comprehensive assessment and randomization to receive either AccessEI, a 6 -10 week online therapist-assisted parenting program, or FTF treatment, whereby they received the same program presented FTF during a 1-week treatment. To control for unavoidable treatment dosage differences in the first study, Study 2 was conducted in which urban families (n ϭ 73) with a child aged 3 to 14 years meeting similar criteria as Study 1 were randomized to receive AccessEI versus FTF treatment. Results: In both studies, improvements in severity of child diagnoses and maternal measures of child behavior showed very large effect sizes for both treatments at posttreatment and 3-month follow-up and did not differ across treatment conditions. There were moderate effect sizes for improvements in parent mental health and no differences across treatment conditions. Conclusions: It is concluded that the effects of the therapist-assisted online parenting interventions for the treatment of child conduct problems were similar to a FTF intervention, providing evidence for the effectiveness of an accessible treatment for rural and remote families. What is the public health significance of this article?The findings of this research suggest that the effects of a therapist-assisted online parenting intervention were similar to a face-to-face intervention in improving child conduct problems. Therapist-assisted online parenting interventions have the potential to increase the accessibility of services for families residing in rural and remote areas, or for those who are unable to attend traditional face-to-face child mental health services.

How Do Mothers’ Parental Attributions Affect Child Outcomes from a Positive Parenting Intervention? A Mediation Study

“…The significance of mediating effects was subsequently assessed by bootstrapping with bias corrected confidence intervals for the indirect effect (10,000 resamples; Hayes 2009). A single-group design was first used to maximise analytic power, which was supported by findings that the intervention was equally efficacious across delivery modes and treatment sites [ 48 – 50 ]. Invariance testing using multigroup analyses examined replicability across treatment sites (group 1: site 1; group 2: site 2) and delivery modes (group 1: face–face; group 2: telehealth).…”

“…All families received the Integrated Family Intervention for Child Conduct Problems [42], a manualised social-learning based parenting intervention shown to be effective in reducing child externalising problems [43][44][45][46][47][48][49][50]. Families participated as part of a randomised control trial evaluating the efficacy of the parenting program in web-based versions that included videoconferencing with a practitioner compared to standard face-face BPT sessions.…”

“…Families participated as part of a randomised control trial evaluating the efficacy of the parenting program in web-based versions that included videoconferencing with a practitioner compared to standard face-face BPT sessions. Details of the programs are provided in [50], with results indicating that the program is equally efficacious in face-face and web-based versions [see also 48,49]. Clinical psychologists with a minimum of at least 1-year Masters Level training with specialist placements in behavioural parent management training administered the treatment.…”

ParentWorks: Evaluation of an Online, Father-Inclusive, Universal Parenting Intervention to Reduce Child Conduct Problems

“…ParentWorks was based on a face-to-face intervention for parents of children with conduct problems [22], for which effectiveness in a telehealth web-based format was previously reported [24]. The intervention was modified to be suitable for a broader community sample of parents, including those with more general concerns about parenting and child behaviour.…”

“…The benchmarking analysis was conducted to evaluate intervention effects against a sample of children who had previously been referred and treated for conduct problems with the core parenting program provided in face-face or telehealth web-based formats [23,24]. Comparisons with the benchmarking samples were limited to children rated as high or very high for conduct problems (face-face: N = 83; web-based: N = 87; ParentWorks: N = 151) and consisted of comparing intervention outcomes on SDQ Conduct Problems using repeated measures ANOVA.…”