Treating young children's disruptive behavior problems: dissemination of an evidence- based parent management training program in the Netherlands

Abstract

High levels of young children’s disruptive behavior problems are persistent, highly prevalent, and a serious public health concern. If left untreated, these behaviors can lead to serious difficulties in broad areas of child and family functioning, and economically impact the wider society. Therefore, early intervention is necessary to protect these children and their parents from a negative developmental trajectory. Reviews of treatment outcome literature for young children with disruptive behavior problems find that interventions involving parents as the primary agent of change remain the most consistently supported. The focus of this thesis was on the theme of dissemination of an evidence-based parent management training program to the Netherlands, and in particular the implementation of Parent-Child Interaction Therapy. The primary aim of this thesis was to study the effectiveness of PCIT in Dutch clinical practice and additionally other components related to dissemination and study of parent management training (PMT) programs were evaluated, including behavioral assessment techniques, treatment attrition, and therapists’ perspectives. The findings from the effectiveness studies on PCIT in this thesis show that PMT programs can be successfully transported to the Netherlands without the need for cultural adaptations and work well in real-world clinical practice. Findings on other implementation outcomes including the therapists’ perspectives on training and the treatment model, and good psychometric properties for the integral behavioral assessment techniques support this conclusion. In the general discussion recommendations are made for future research on long-term maintenance, effective elements, and treatment retention in order to understand how benefits of PMT programs for children, their families, and the greater society can be maximized.