Research
Parent Management Training (PMT)
Overall, perhaps no other technique has been as carefully documented and empirically supported as PMT in treating conduct problems. A unique feature of PMT is the abundance of research on child, parent, and family factors that moderate treatment effects. Moreover, PMT, either alone or in combination with other techniques, has been applied with promising effects to other populations including children on the autism spectrum. The principles and procedures on which PMT relies have also been applied in many settings including schools, institutions, community homes, day-care facilities, and facilities for the elderly.
1. PMT is one of the most extensively studied therapies for children and has been shown to be effective in decreasing oppositional, aggressive, and antisocial behavior (for reviews of research, see Dumas, 1989; Forehand & Long, 1988; Kazdin, 1985; Miller & Prinz, 1990; Moreland, Schwebel, Beck, & Wells, 1982).
2. Randomized controlled trials have found that PMT is more effective in changing antisocial behavior and promoting prosocial behavior than many other treatment (e.g. relationship, play therapy, family therapies, varied community services) and control conditions (e.g. waiting-list, "attention-placebo"). Follow-up data have shown that gains are maintained from posttreatment to 1 and 3 years after treatment has ended.
3. One research team found that noncompliant children treated by parent training were functioning as well as nonclinic individuals approximately 14 years later (Long, Forehand, Wierson, & Morgan, 1994).
4. The benefits of PMT often generalize to areas that are not focused on directly during therapy. For example, improvements in parental adjustment and functioning, marital satisfaction, and sibling behavior have been found following therapy.
5. Results strongly suggest that parenting programs reduces the chance that conduct disorder persists into adulthood and are cost-saving to the public sector within 5-8 years under base case conditions. Total savings to society over 25 years are estimated at £16,435 per family, which compares with an intervention cost in the range of £952-£2,078 (2008/09 prices).
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Reprinted from: Feldman, J. & Kazdin, A. E. (1995). Parent management training for oppositional and conduct problem children. The Clinical Psychologist, 48(4), 3-5.
Attention Deficit and Hyperactivity Disorder and PMT
"Many physicians and parents consider behavior therapy an alternative treatment option for ADHD, used in conjunction with ADHD medication to help kids learn skills like organization or time management that prescriptions cannot teach. New research shows that behavior therapy works best when it is introduced before medication. Children who were treated with behavior therapy first, and given additional medication if needed, showed faster behavioral improvement than those who began with a stimulant regimen. What’s more, the parents of children who began with behavioral therapy spent an average of $700 less annually on treatment."
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Problem Solving Skills Training (PSST) and PMT
This study evaluated the effects of problem-solving skills training (PSST) and parent management training (PMT) on children (N = 97, ages 7-13 years) referred for severe antisocial behavior. Children and families were assigned randomly to 1 of 3 conditions: PSST, PMT, or PSST and PMT combined. It was predicted that (a) each treatment would improve child functioning (reduce overall deviance and aggressive, antisocial, and delinquent behavior, and increase prosocial competence); and (b) PSST and PMT combined would lead to more marked, pervasive, and durable changes in child functioning and greater changes in parent functioning (parental stress, depression, and overall symptoms).
Expectations were supported by results at posttreatment and 1-year follow-up. PSST and PMT combined led to more marked changes in child and parent functioning and placed a greater proportion of youth within the range of nonclinic (normative) levels of functioning.
J Consult Clin Psychol. 1992 Oct;60(5):733-47. Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. Kazdin AE, Siegel TC, Bass D. Department of Psychology, Yale University, New Haven, Connecticut 06520-7447
This study evaluated the effects of problem-solving skills training (PSST) and parent management training (PMT) on children (N = 97, ages 7-13 years) referred for severe antisocial behavior. Children and families were assigned randomly to 1 of 3 conditions: PSST, PMT, or PSST and PMT combined. It was predicted that (a) each treatment would improve child functioning (reduce overall deviance and aggressive, antisocial, and delinquent behavior, and increase prosocial competence); and (b) PSST and PMT combined would lead to more marked, pervasive, and durable changes in child functioning and greater changes in parent functioning (parental stress, depression, and overall symptoms).
Expectations were supported by results at posttreatment and 1-year follow-up. PSST and PMT combined led to more marked changes in child and parent functioning and placed a greater proportion of youth within the range of nonclinic (normative) levels of functioning.
J Consult Clin Psychol. 1992 Oct;60(5):733-47. Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. Kazdin AE, Siegel TC, Bass D. Department of Psychology, Yale University, New Haven, Connecticut 06520-7447
Internet-Assisted Parent Training Intervention for Disruptive Behavior in 4-Year-Old Children
A Randomized Clinical Trial
Conclusions and Relevance: The study reveals the effectiveness and feasibility of an Internet-assisted parent training intervention offered for parents of preschool children with disruptive behavioral problems screened from the whole population. The strategy of population-based screening of children at an early age to offering parent training using digital technology and telephone coaching is a promising public health strategy for providing early intervention for a variety of child mental health problems.
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A Randomized Clinical Trial
Conclusions and Relevance: The study reveals the effectiveness and feasibility of an Internet-assisted parent training intervention offered for parents of preschool children with disruptive behavioral problems screened from the whole population. The strategy of population-based screening of children at an early age to offering parent training using digital technology and telephone coaching is a promising public health strategy for providing early intervention for a variety of child mental health problems.
Click here for the full study
Parent Management Training and Asperger Syndrome
This controlled trial of a parent management intervention aimed to increase parental competence in management of problem behaviours associated with Asperger syndrome. Results showed parents reporting fewer and lower intensity of problem behaviours and increased social interactions at 4 weeks and 3 months. Results held across formats and suggest that parent management training can provide an effective intervention for parents of a child with Asperger syndrome. Group differences on outcome measures and in the use of strategies are discussed along with limitations of the study.
A randomized controlled trial to evaluate a parent based intervention.
Sofronoff K, Leslie A, Brown W. Source University of Queensland, Australia.
[email protected]
Click here for the full study
This controlled trial of a parent management intervention aimed to increase parental competence in management of problem behaviours associated with Asperger syndrome. Results showed parents reporting fewer and lower intensity of problem behaviours and increased social interactions at 4 weeks and 3 months. Results held across formats and suggest that parent management training can provide an effective intervention for parents of a child with Asperger syndrome. Group differences on outcome measures and in the use of strategies are discussed along with limitations of the study.
A randomized controlled trial to evaluate a parent based intervention.
Sofronoff K, Leslie A, Brown W. Source University of Queensland, Australia.
[email protected]
Click here for the full study
References
A. Background Research
Reviews of the outcome evidence, as well findings related to moderators of treatment, generalization, and maintenance of changes, can be obtained from the following sources:
Dumas, J.E. (1989). Treating antisocial behavior in children: Child family approaches. Clinical Psychology Review, 9, 197-222.
Forehand, R., & Long, N. (1988). Outpatient treatment of the acting out child: Procedures, long-term follow-up data, and clinical problems. Advances in Behaviour Research and Therapy 10, 129-177.
Kazdin, A. E. (1985). Treatment of antisocial behavior in children and adolescents. Homewood, IL: Dorsey Press.
Long, P., Forhand, R., Wierson, M., & Morgan, A. (1994). Does parent training with young noncompliant children have long-term effects? Behaviour Research and Therapy, 32, 101-107.
Miller, G. E., & Prinz, R. J. (1990). Enhancement of social learning family interventions for child conduct disorder. Psychological Bulletin, 108, 291-307.
Moreland, J. R., Schwebel, A.I., Beck, S., & Wells, R. (1982). Parents as therapists: A review of the behavior therapy parent training literature - 1975 to 1981. Behavior Modification, 6, 250-276.
B. Clinical References
Materials that describe the procedures and methods used in training for oppositional and antisocial children can be found in the following sources:
Forehand, R., & McMahon, R.J. (1981). Helping the noncompliant child: A clinician's guide to parent training. New York: Guilford.
Sanders, M.R., & Dadds, M.R. (1993). Behavioral family interventions. Needham Heights, MA: Allyn & Bacon.
Webster-Stratton, C., & Herbert, M. (1994). Troubled families-problem children: Working with parents: a collaborative process. Chichester, England: John Wiley.
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A. Background Research
Reviews of the outcome evidence, as well findings related to moderators of treatment, generalization, and maintenance of changes, can be obtained from the following sources:
Dumas, J.E. (1989). Treating antisocial behavior in children: Child family approaches. Clinical Psychology Review, 9, 197-222.
Forehand, R., & Long, N. (1988). Outpatient treatment of the acting out child: Procedures, long-term follow-up data, and clinical problems. Advances in Behaviour Research and Therapy 10, 129-177.
Kazdin, A. E. (1985). Treatment of antisocial behavior in children and adolescents. Homewood, IL: Dorsey Press.
Long, P., Forhand, R., Wierson, M., & Morgan, A. (1994). Does parent training with young noncompliant children have long-term effects? Behaviour Research and Therapy, 32, 101-107.
Miller, G. E., & Prinz, R. J. (1990). Enhancement of social learning family interventions for child conduct disorder. Psychological Bulletin, 108, 291-307.
Moreland, J. R., Schwebel, A.I., Beck, S., & Wells, R. (1982). Parents as therapists: A review of the behavior therapy parent training literature - 1975 to 1981. Behavior Modification, 6, 250-276.
B. Clinical References
Materials that describe the procedures and methods used in training for oppositional and antisocial children can be found in the following sources:
Forehand, R., & McMahon, R.J. (1981). Helping the noncompliant child: A clinician's guide to parent training. New York: Guilford.
Sanders, M.R., & Dadds, M.R. (1993). Behavioral family interventions. Needham Heights, MA: Allyn & Bacon.
Webster-Stratton, C., & Herbert, M. (1994). Troubled families-problem children: Working with parents: a collaborative process. Chichester, England: John Wiley.
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