Advertisement

Child Psychiatry & Human Development

, Volume 50, Issue 1, pp 1–12 | Cite as

An Open Trial of Parent–Child Care (PC-CARE)-A 6-Week Dyadic Parenting Intervention for Children with Externalizing Behavior Problems

  • Susan G. TimmerEmail author
  • Brandi Hawk
  • Lindsay A. Forte
  • Deanna K. Boys
  • Anthony J. Urquiza
Original Article

Abstract

Research shows that parenting interventions are plagued with the problem of early treatment termination. A brief 6-week intervention, parent–child care (PC-CARE) was developed to minimize the time investment for parents while maximizing the probability of improving behavioral problems of their 1–10 year old children. The purpose of this study was to determine the feasibility of PC-CARE and examine preliminary outcomes. The data were collected as part of an open trial in a community mental health clinic and included pre- and post-treatment performance outcomes, weekly measures of treatment progress, and assessments of treatment fidelity. Participants were 64 children and their primary caregivers, referred by physicians, social workers, or self-referred for help with their children’s difficult behaviors. The retention rate was 94%. Results of analyses pre- to post-intervention scores showed significant improvements in child behavioral problems as well as improvements in parenting stress and positive parenting skills. The findings suggest that PC-CARE may be a beneficial treatment for children with disruptive behaviors, encourage future research into the efficacy of this brief parenting intervention, and its effectiveness in other populations and contexts.

Keywords

Brief parenting intervention Child behavior problems Treatment outcomes Open trial Treatment fidelity 

References

  1. 1.
    Houtrow AJ, Okumura MJ (2011) Pediatric mental health problems and associated burden on families. Vulnerable Child Youth Stud 6(3):222–223CrossRefGoogle Scholar
  2. 2.
    Merikangas KR, He JP, Brody D, Fisher PW, Bourdon K, Koretz DS (2010) Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics 125(1):75–81CrossRefGoogle Scholar
  3. 3.
    Simon AE, Pastor PN, Reuben CA, Huang LN, Goldstrom ID (2015) Use of mental health services by children ages six to 11 with emotional or behavioral difficulties. Psychiatr Serv 66(9):930–937CrossRefGoogle Scholar
  4. 4.
    Owens PL, Hoagwood K, Horwitz SM, Leaf PJ, Poduska JM, Kellam SG et al (2002) Barriers to children’s mental health services. J Am Acad Child Adolesc Psychiatry 41(6):731–738CrossRefGoogle Scholar
  5. 5.
    Substance Abuse and Mental Health Services Administration (2013) Behavioral Health, United States, 2012. HHS Publication No (SMA) 13-4797. Substance Abuse, RockvilleGoogle Scholar
  6. 6.
    Bethell C, Reuland C, Schor E, Abrahms M, Halfon N (2011) Rates of parent-centered developmental screening: disparities and links to services access. Pediatrics 128(1):146–155CrossRefGoogle Scholar
  7. 7.
    Harrison ME, McKay MM, Bannon WM (2004) Inner-city child mental health service use: the real question is why youth and families do not use services. Community Ment Health J 40(2):119–131CrossRefGoogle Scholar
  8. 8.
    Kaminski JW, Claussen AH (2017) Evidence base update for psychosocial treatments for disruptive behaviors in children. J Clin Child Adol Psychol 46:1–23CrossRefGoogle Scholar
  9. 9.
    Kazdin AE, Holland L, Crowley M (1997) Family experience of barriers to treatment and premature termination from child therapy. J Consult Clin Psychol 65(3):453–463CrossRefGoogle Scholar
  10. 10.
    Nowak C, Heinrichs N (2008) A comprehensive meta-analysis of Triple P-Positive Parenting Program using hierarchical linear modeling: effectiveness and moderating variables. Clin Child Fam Psychol Rev 11:114–144CrossRefGoogle Scholar
  11. 11.
    Timmer ST, Urquiza AJ (2014) Taking it to the street: disseminating empirically based treatments. In: Timmer SG, Urquiza AJ (eds) Evidence-based approaches for the treatment of maltreated children: considering core components and treatment effectiveness. Springer Science + Business Media, New YorkCrossRefGoogle Scholar
  12. 12.
    Tully LA, Hunt C (2017) Brief parenting interventions for children at risk of externalizing behavior problems: a systematic review. J Child Fam Stud 25:705–719CrossRefGoogle Scholar
  13. 13.
    Sanders MR, Kirby JN, Tellegen CI, Day JJ (2014) The Triple P-Positive Parenting Program: a systematic review and meta-analysis of a multi-level system of parenting support. Clin Psychol Rev 34:337–357CrossRefGoogle Scholar
  14. 14.
    Kaminski JW, Valle LA, Filene JH, Boyle CL (2008) A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol 36:567–589CrossRefGoogle Scholar
  15. 15.
    Barnett ML, Niec LN, Acevedo-Polakovich ID (2014) Assessing the key to effective coaching in parent-child interaction therapy: the therapist-parent interaction coding system. J Psychopathol Behav 36(2):211–213CrossRefGoogle Scholar
  16. 16.
    Lau A, Barnett M, Stadnick N, Saifan D, Regan J, Stirman SW, Roesch S, Brookman-Frazee L (2017) Therapist report of adaptiations to delivery of evidence-based practices within a system-driven reform of publicly funded children’s mental health services. J Consult Clin Psychol 85(7):664–675CrossRefGoogle Scholar
  17. 17.
    Ainsworth MD (1964) Patterns of attachment behavior shown by the infant in interaction with his mother. Merrill Palmer Q Beh 10:51–58Google Scholar
  18. 18.
    Strand PS, Wahler RG, Herring M (2001) The impact of behavior-specific and behavior-nonspecific reinforcement on child compliance to mother directives. Behav Res Ther 39:1085–1097CrossRefGoogle Scholar
  19. 19.
    Bandura A (1977) Social learning theory. General Learning Press, New YorkGoogle Scholar
  20. 20.
    McNeil CB, Hembree-Kigin TL (2010) Parent-child interaction therapy, 2nd edn. Springer, New YorkCrossRefGoogle Scholar
  21. 21.
    McMahon RJ, Forehand RL (2003) Helping the non-compliant child: family-based treatment for oppositional behavior. Guilford, New YorkGoogle Scholar
  22. 22.
    Linares LO, Montalto D, Li M, Oza VS (2006) A promising parenting intervention in foster care. J Consult Clin Psy 74(1):32–41CrossRefGoogle Scholar
  23. 23.
    Sanders MR (1999) The triple P-positive parenting program: towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clin Child Fam Psychol Rev 2:71–90CrossRefGoogle Scholar
  24. 24.
    Harwood MD, Eyberg SE (2006) Child-directed interaction: prediction of change in impaired mother child functioning. J Abnorm Psychol 34(3):335–347CrossRefGoogle Scholar
  25. 25.
    Eyberg SM, Pincus D (1999) Eyberg child behavior inventory and Sutter–Eyberg student behavior inventory-revised: professional manual. Psychological Assessment Resources, OdessaGoogle Scholar
  26. 26.
    LeBuffe PA, Naglieri JA (2012) Devereux early childhood assessment user’s guide and technical manual. Kaplan Early Learning Company, Lewisville, NCGoogle Scholar
  27. 27.
    Matson JL, Mahan S, LoVullo SV (2009) Parent training: a review of methods for children with developmental disabilities. Res Dev Disabil 30:961–968CrossRefGoogle Scholar
  28. 28.
    Eyberg SM, Robinson E (1983) Conduct problem behavior: sandardization of a behavior rating scale with adolescents. J Clin Child Psychol 12:347–354Google Scholar
  29. 29.
    Eyberg SM, Ross AW (1978) Assessment of child behavior problems: the validation of a new inventory. J Clin Child Psychol 7:113–116CrossRefGoogle Scholar
  30. 30.
    Robinson E, Eyberg SM, Ross AW (1980) The standardization of an inventory of child problematic conduct behaviors. J Clin Child Psychol 9:22–28CrossRefGoogle Scholar
  31. 31.
    Abidin RR (2012) Parenting Stress Index, 4th edn. Psychological Assessment Resources, OdessaGoogle Scholar
  32. 32.
    Timmer ST, Hawk BH, Forte LA, Boys DK, Urquiza AJ (2016) Brief family life questionnaire. In: Timmer et al (eds) PC-CARE: course of treatment manual. Unpublished manuscript, Sacramento, CAGoogle Scholar
  33. 33.
    Timmer ST, Forte LA, Hawk BH, Boys DK, Urquiza AJ (2017) Psychometric properties of the weekly assessment of child behavior. Unpublished manuscript, SacramentoGoogle Scholar
  34. 34.
    Boys DK, Timmer ST, Hawk BH, Forte LA, Urquiza AJ (2016) PC-CARE coding system. In: Timmer et al (eds) PC-CARE: Course of treatment manual. Unpublished manuscript, SacramentoGoogle Scholar
  35. 35.
    Eyberg SE, Nelson MM, Ginn NC, Bhuiyan N, Boggs SR (2013) Dyadic parent-child interaction coding system (DPICS): comprehensive manual for research and training. PCIT International, GainesvilleGoogle Scholar
  36. 36.
    Cohen J (1988) Statistical power analysis for the behavioral sciences, 2nd edn. Lawrence Erlbaum, HillsdaleGoogle Scholar
  37. 37.
    Gupta SK (2011) Intention-to-treat concept: a review. Perspect Clin Res 2:109–112CrossRefGoogle Scholar
  38. 38.
    Funderburk BW, Eyberg SM, Rich BA, Behar L (2003) Further psychometric evaluation of the Eyberg and Behar rating scales for parents and teachers of preschoolers. Early Educ Dev 14(1):67–81CrossRefGoogle Scholar
  39. 39.
    Aarons GA, Wells RS, Zagursky K, Fettes DL, Palinkas LA (2009) Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis. Am J Public Health 99(11):2087–2095CrossRefGoogle Scholar
  40. 40.
    Timmer ST, Urquiza AJ (2014) The bridge from research to practice-just leap across the last bit. In: Timmer ST, Urquiza AJ (eds) Evidence-based approaches for the treatment of maltreated children: considering core components and treatment effectiveness. Springer Science + Business Media, New YorkCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Susan G. Timmer
    • 1
    Email author
  • Brandi Hawk
    • 1
  • Lindsay A. Forte
    • 1
  • Deanna K. Boys
    • 1
  • Anthony J. Urquiza
    • 1
  1. 1.Department of Pediatrics, CAARE Diagnostic and Treatment Center, Children’s HospitalUniversity of California at DavisSacramentoUSA

Personalised recommendations