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Behavioral and Nondirective Guided Self-Help for Parents of Children with Externalizing Behavior: Mediating Mechanisms in a Head-To-Head Comparison

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Abstract

Parent training (PT) delivered as a guided self-help intervention may be a cost- and time-effective intervention in the treatment of children with externalizing disorders. In face-to-face PT, parenting strategies have repeatedly been identified as mediating mechanisms for the decrease of children’s problem behavior. Few studies have examined possible mediating effects in guided self-help interventions for parents. The present study aimed to investigate possible mediating variables of a behaviorally oriented guided self-help program for parents of children with externalizing problems compared to a nondirective intervention in a clinical sample. A sample of 110 parents of children with externalizing disorders (80 % boys) were randomized to either a behaviorally oriented or a nondirective guided self-help program. Four putative mediating variables were examined simultaneously in a multiple mediation model using structural equation modelling. The outcomes were child symptoms of ADHD and ODD as well as child externalizing problems, assessed at posttreatment. Analyses showed a significant indirect effect for dysfunctional parental attributions in favor of the group receiving the behavioral program, and significant effects of the behavioral program on positive and negative parenting and parental self-efficacy, compared to the nondirective intervention. Our results indicate that a decrease of dysfunctional parental attributions leads to a decrease of child externalizing problems when parents take part in a behaviorally oriented guided self-help program. However, none of the putative mediating variables could explain the decrease in child externalizing behavior problems in the nondirective group. A change in dysfunctional parental attributions should be considered as a possible mediator in the context of PT.

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Authors and Affiliations

  1. Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Cologne, Germany

    Josepha Katzmann, Lisa Greimel, Stephanie Imort, Julia Pinior, Kristin Scholz & Manfred Döpfner

  2. School of Child and Adolescent Psychotherapy, University Hospital of Cologne, Cologne, Germany

    Christopher Hautmann & Manfred Döpfner

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  1. Josepha Katzmann
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  2. Christopher Hautmann
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  3. Lisa Greimel
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  4. Stephanie Imort
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  5. Julia Pinior
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  6. Kristin Scholz
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  7. Manfred Döpfner
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Correspondence to Josepha Katzmann.

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Funding

This study was funded by Deutsche Forschungsgemeinschaft (DFG; German Research Foundation) (grant number DO 620/5–1).

Conflict of Interest

Josepha Katzmann, Christopher Hautmann, Stephanie Imort, Julia Pinior, Kristin Scholz and Manfred Döpfner are authors of the parent booklets used in the behavioral intervention of this study. Manfred Döpfner received income as Head of the School for Child and Adolescent Behavior Therapy at the University of Cologne and royalties from treatment manuals, books and psychological tests published by Guilford, Hogrefe, Enke, Beltz, and Huber. Lisa Greimel declares that she has no conflict of interest.

Ethical Approval

The study was approved by the ethics committee of the University Hospital of Cologne (ref: 09–123).

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Katzmann, J., Hautmann, C., Greimel, L. et al. Behavioral and Nondirective Guided Self-Help for Parents of Children with Externalizing Behavior: Mediating Mechanisms in a Head-To-Head Comparison. J Abnorm Child Psychol 45, 719–730 (2017). https://doi.org/10.1007/s10802-016-0195-z

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