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Prevention Science

, Volume 20, Issue 1, pp 78–88 | Cite as

Does Giving Parents Their Choice of Interventions for Child Behavior Problems Improve Child Outcomes?

  • Abigail H. GewirtzEmail author
  • Susanne S. Lee
  • Gerald J. August
  • Yaliu He
Article

Abstract

Empowering consumers to be active decision-makers in their own care is a core tenet of personalized, or precision medicine. Nonetheless, there is a dearth of research on intervention preferences in families seeking interventions for a child with behavior problems. Specifically, the evidence is inconclusive as to whether providing parents with choice of intervention improves child/youth outcomes (i.e., reduces externalizing problems). In this study, 129 families presenting to community mental health clinics for child conduct problems were enrolled in a doubly randomized preference study and initially randomized to choice or no-choice conditions. Families assigned to the choice condition were offered their choice of intervention from among three different formats of the Parent Management Training-Oregon Model/PMTO (group, individual clinic, home based) and services-as-usual (child-focused therapy). Those assigned to the no-choice condition were again randomized, to one of the four intervention conditions. Intent-to-treat analyses revealed partial support for the effect of parental choice on child intervention outcomes. Assignment to the choice condition predicted teacher-reported improved child hyperactivity/inattention outcomes at 6 months post-treatment completion. No main effect of choice on parent reported child outcomes was found. Moderation analyses indicated that among parents who selected PMTO, teacher report of hyperactivity/inattention was significantly improved compared with parents selecting SAU, and compared with those assigned to PMTO within the no-choice condition. Contrary to hypotheses, teacher report of hyperactivity/inattention was also significantly improved for families assigned to SAU within the no-choice condition, indicating that within the no-choice condition, SAU outperformed the parenting interventions. Implications for prevention research are discussed.

Keywords

PMTO Choice of intervention Parenting Child outcomes 

Notes

Funding

The research reported here was funded by grant no. P20 MH 079906 from the National Institute of Mental Health to Gerald August (Center PI) and Abigail Gewirtz (PI of this study)

Compliance with Ethical Standards

Conflict of Interest

The authors declare they have no conflicts of interest.

Ethical Approval

This study was approved by the University of Minnesota IRB and the Human Subjects Research Protection Board of the State of Michigan’s Department of Community Health. 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.

Informed Consent

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

References>

  1. Arnkoff, D. B., Glass, C. R., & Shapiro, S. J. (2002). Psychotherapy relationships that work: Therapist contributions and responsiveness to patients. In J. C. Norcross (Ed.), Expectations and preferences (pp. 335–356). New York: Oxford University Press.Google Scholar
  2. Bierman, K. L., Nix, R. L., Maples, J. J., Murphy, S. A., & Conduct Problems Prevention Research Group. (2006). Examining clinical judgment in an adaptive intervention design: The fast track program. Journal of Consulting and Clinical Psychology, 74, 468–481.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Brewin, C. R., & Bradley, C. (1989). Patient preferences and randomised clinical trials. BMJ, 299, 313–315.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Briggs-Gowan, M. J., Horwitz, S. M., Schwab-Stone, M. E., Leventhal, J. M., & Leaf, P. J. (2000). Mental health in pediatric settings: Disorders and factors related to service use. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 841–849.CrossRefPubMedGoogle Scholar
  5. Broman, C. L. (2012). Race differences in the receipt of mental health services among young adults. Psychological Services, 9, 38–48.CrossRefPubMedGoogle Scholar
  6. Burke, J. D., Loeber, R., & Birmaher, B. (2002). Oppositional defiant disorder and conduct disorder: A review of the past 10 years, part II. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1275–1293.CrossRefPubMedGoogle Scholar
  7. Burke, L. E., Warziski, M., Styn, M. A., Music, E., Hudson, A. G., & Sereika, S. M. (2008). A randomized clinical trial of a standard versus vegetarian diet for weight loss: The impact of treatment preference. International Journal of Obesity, 32, 166–176.CrossRefPubMedGoogle Scholar
  8. Chilvers, C., Dewey, M., Fielding, K., Gretton, V., Miller, P., Palmer, B., … Counselling versus Antidepressants in Primary Care Study Group. (2001). Antidepressant drugs and generic counselling for treatment of major depression in primary care: Randomised trial with patient preference arms. BMJ , 322, 772–775.
  9. Clark, N. M., Janz, N. K., Dodge, J. A., Mosca, L., Lin, X., Long, Q., et al. (2008). The effect of patient choice of intervention on health outcomes. Contemporary Clinical Trials, 29, 679–686.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Collins, F. S., & Varmus, H. (2015). A new initiative on precision medicine. New England Journal of Medicine, 372, 793–795.CrossRefGoogle Scholar
  11. Cunningham, C. E., Chen, Y., Deal, K., Rimas, H., McGrath, P., Reid, G., et al. (2013). The interim service preferences of parents waiting for children’s mental health treatment: A discrete choice conjoint experiment. Journal of Abnormal Child Psychology, 41, 865–877.CrossRefPubMedGoogle Scholar
  12. Cunningham, C. E., Deal, K., Rimas, H., Buchanan, D. H., Gold, M., Sdao-Jarvie, K., & Boyle, M. (2008). Modeling the information preferences of parents of children with mental health problems. Journal of Abnormal Child Psychology, 36, 1123–1138.CrossRefGoogle Scholar
  13. Dalsgaard, S., Mortensen, P. B., Frydenberg, M., & Thomsen, P. H. (2013). Long-term criminal outcome of children with attention deficit hyperactivity disorder. Criminal Behaviour and Mental Health, 23, 86–98.CrossRefPubMedGoogle Scholar
  14. Derogatis, L. R., & Savitz, K. L. (2000). The SCL–90–R and Brief Symptom Inventory (BSI) in primary care. Lawrence Erlbaum Associates Publishers.
  15. Derogatis, L. R. (2001). BSI 18, Brief symptom inventory 18: administration, scoring and procedures manual. Minneapolis: NCS Pearson Incorporated.Google Scholar
  16. Dishion, T. J., Shaw, D., Connell, A., Gardner, F., Weaver, C., & Wilson, M. (2008). The family check-up with high-risk indigent families: Preventing problem behavior by increasing parents’ positive behavior support in early childhood. Child Development, 79, 1395–1414.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Dobscha, S. K., Corson, K., & Gerrity, M. S. (2007). Depression treatment preferences of VA primary care patients. Psychosomatics, 48, 482–488.CrossRefPubMedGoogle Scholar
  18. Forgatch, M. S., & DeGarmo, D. S. (2011). Sustaining fidelity following the nationwide PMTO™ implementation in Norway. Prevention Science, 12, 235–246.
  19. Forgatch, M. S., & Gewirtz, A. H. (2017). Evidence-based psychotherapies for children and adolescents, 3rd ed. In J. R. Weisz & A. E. Kazdin (Eds.), Evolution of Parent Management Training-Oregon Model. New York: Guildford Press.Google Scholar
  20. Forgatch, M. S., Knutson, N., & Mayne, T. (1992). Coder impressions of ODS lab tasks. Eugene, OR: Oregon Social Learning Center.
  21. Forgatch, M. S., Patterson, G. R., Degarmo, D. S., & Beldavs, Z. G. (2009). Testing the Oregon delinquency model with 9-year follow-up of the Oregon Divorce Study. Development and Psychopathology, 21, 637–660.CrossRefGoogle Scholar
  22. Forgatch, M. S., Patterson, G. R., & Gewirtz, A. H. (2013). Looking forward: The promise of widespread implementation of parent training programs. Perspectives on Psychological Science, 8, 682–694.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Gewirtz, A. H., DeGarmo, D. S., Lee, S., Morrell, N., & August, G. (2015). Two-year outcomes of the Early Risers prevention trial with formerly homeless families residing in supportive housing. Journal of Family Psychology, 29, 242–252.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Gewirtz, A.H. (2014-2019). Comparing web, group, and telehealth formats of a military parenting program. Grant # W81XWH141014, Department of Defense.Google Scholar
  25. Goodman, R. (2001). Psychometric properties of the strengths and difficulties questionnaire. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1337–1345.CrossRefGoogle Scholar
  26. Goodman, R., Meltzer, H., & Bailey, V. (1998). The strengths and difficulties questionnaire: A pilot study on the validity of the self-report version. European Child & Adolescent Psychiatry, 7, 125–130.CrossRefGoogle Scholar
  27. Gopalan, G., Goldstein, L., Klingenstein, K., Sicher, C., Blake, C., & McKay, M. M. (2010). Engaging families into child mental health treatment: Updates and special considerations. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19, 182.PubMedPubMedCentralGoogle Scholar
  28. Graham, J. W. (2009). Missing data analysis: Making it work in the real world. Annual Review of Psychology, 60, 549–576.CrossRefGoogle Scholar
  29. Haggerty, K. P., Skinner, M. L., MacKenzie, E. P., & Catalano, R. F. (2007). A randomized trial of parents who care. Prevention Science, 8, 249–260.CrossRefPubMedGoogle Scholar
  30. Heinrichs, N., Bertram, H., Kuschel, A., & Hahlweg, K. (2005). Parent recruitment and retention in a universal prevention program for child behavior and emotional problems: Barriers to research and program participation. Prevention Science, 6, 275–286.CrossRefPubMedGoogle Scholar
  31. He, B. M., Schmitz, A., & Merikangas, K. R. (2013). The Strengths and Difficulties Questionnaire (SDQ): The factor structure and scale validation in U.S. adolescents. Journal of Abnormal Child Psychology, 41, 583–595.CrossRefPubMedGoogle Scholar
  32. He, Y., Gewirtz, A., Lee, S., Morrell, N., & August, G. (2016). A randomized preference trial to inform personalization of a parent training program implemented in community mental health clinics. Translational Behavioral Medicine, 6, 73–80.CrossRefPubMedGoogle Scholar
  33. Kocsis, J. H., Leon, A. C., Markowitz, J. C., Manber, R., Arnow, B., Klein, D. N., & Thase, M. E. (2009). Patient preference as a moderator of outcome for chronic forms of major depressive disorder treated with nefazodone, cognitive behavioral analysis system of psychotherapy, or their combination. Journal of Clinical Psychiatry, 70, 354–361.CrossRefPubMedGoogle Scholar
  34. Kwan, B. M., Dimidjian, S., & Rizvi, S. L. (2010). Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression. Behaviour Research and Therapy, 48, 799–804.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Littell, R. C., Stroup, W. W., Milliken, G. A., Wolfinger, R. D., & Schabenberger, O. (2006). SAS for Mixed Models, Second Edition . SAS Institute.
  36. Long, Q., Little, R. J., & Lin, X. (2008). Causal inference in hybrid intervention trials involving treatment choice. Journal of the American Statistical Association, 103, 474–484.CrossRefGoogle Scholar
  37. Marcus, S. M., Stuart, E. A., Wang, P., Shadish, W. R., & Steiner, P. M. (2012). Estimating the causal effect of randomization versus treatment preference in a doubly randomized preference trial. Psychological Methods, 17, 244–254.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Marmorstein, N. R., & Iacono, W. G. (2004). Major depression and conduct disorder in youth: Associations with parental psychopathology and parent–child conflict. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 45, 377–386.CrossRefPubMedGoogle Scholar
  39. McCaffery, K. J., Turner, R., Macaskill, P., Walter, S. D., Chan, S. F., & Irwig, L. (2011). Determining the impact of informed choice: Separating treatment effects from the effects of choice and selection in randomized trials. Medical Decision Making, 31, 229–236.CrossRefPubMedGoogle Scholar
  40. McCoach, D. B., & Kaniskan, B. (2010). Using time-varying covariates in multilevel growth models. Frontiers in Psychology, 1, 17.PubMedPubMedCentralGoogle Scholar
  41. Merikangas, K. R., He, J.-P., Brody, D., Fisher, P. W., Bourdon, K., & Koretz, D. S. (2010). Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics, 125, 75–81.CrossRefGoogle Scholar
  42. Mian, N. D., Eisenhower, A. S., & Carter, A. S. (2015). Targeted prevention of childhood anxiety. American Journal of Community Psychology, 55, 58–69.CrossRefPubMedGoogle Scholar
  43. Ng, M. Y., & Weisz, J. R. (2016). Annual research review: Building a science of personalized intervention for youth mental health. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 57, 216–236.CrossRefPubMedGoogle Scholar
  44. Patterson, G. R., DeBaryshe, B. D., & Ramsey, E. (1989). A developmental perspective on antisocial behavior. American Psychologist, 44, 329–335.CrossRefGoogle Scholar
  45. Patterson, G. R., DeGarmo, D. S., & Knutson, N. (2000). Hyperactive and antisocial behaviors: Comorbid or two points in the same process? Development and Psychopathology, 12, 91–106.CrossRefPubMedGoogle Scholar
  46. Sandler, I., Ingram, A., Wolchik, S., Tein, J.-Y., & Winslow, E. (2015). Long-term effects of parenting-focused preventive interventions to promote resilience of children and adolescents. Child Development Perspectives, 9, 164–171.CrossRefPubMedPubMedCentralGoogle Scholar
  47. Schatz, N. K., Fabiano, G. A., Cunningham, C. E., dosReis, S., Waschbusch, D. A., Jerome, S., … Morris, K. L. (2015). Systematic review of patients’ and parents’ preferences for ADHD treatment options and processes of care. The Patient, 8, 483–497.CrossRefPubMedGoogle Scholar
  48. Stanger, C., & Lewis, M. (1993). Agreement among parents, teachers, and children on internalizing and externalizing behavior problems. Journal of Clinical Child Psychology, 22, 107–116.CrossRefGoogle Scholar
  49. Street Jr., R. L., Elwyn, G., & Epstein, R. M. (2012). Patient preferences and healthcare outcomes: An ecological perspective. Expert Review of Pharmacoeconomics & Outcomes Research, 12, 167–180.CrossRefGoogle Scholar
  50. Swift, J. K., Callahan, J. L., & Vollmer, B. M. (2011). Preferences. Journal of Clinical Psychology, 67, 155–165.CrossRefPubMedGoogle Scholar
  51. Torgerson, D. J., & Sibbald, B. (1998). Understanding controlled trials. What is a patient preference trial? BMJ, 316, 360.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Turner, E. A., Jensen-Doss, A., & Heffer, R. W. (2015). Ethnicity as a moderator of how parents’ attitudes and perceived stigma influence intentions to seek child mental health services. Cultural Diversity & Ethnic Minority Psychology, 21, 613–618.CrossRefGoogle Scholar
  53. Webster-Stratton, C., Reid, M. J., Hammond, M. (2001). Preventing conduct problems, promoting social competence: a parent and teacher training partnership in Head Start. Journal of Clinical Child Psychology, 30(3),283-302.Google Scholar
  54. Winston, K., Grendarova, P., & Rabi, D. (2017). Video-based patient decision aids: A scoping review. Patient Education and Counseling.Google Scholar
  55. Wymbs, F. A., Cunningham, C. E., Chen, Y., Rimas, H. M., Deal, K., Waschbusch, D. A., & Pelham, W. E., Jr. (2015). Examining parents’ preferences for group and individual parent training for children with ADHD symptoms. Journal of Clinical Child and Adolescent Psychology, 1–18.Google Scholar
  56. Yancy Jr., W. S., McVay, M. A., & Voils, C. I. (2015). Effect of allowing choice of diet on weight loss—in response. Annals of Internal Medicine, 163, 805–806.CrossRefPubMedGoogle Scholar

Copyright information

© Society for Prevention Research 2018

Authors and Affiliations

  • Abigail H. Gewirtz
    • 1
    Email author
  • Susanne S. Lee
    • 2
  • Gerald J. August
    • 3
  • Yaliu He
    • 4
  1. 1.Department of Family Social Science & Institute of Child DevelopmentUniversity of MinnesotaSt. PaulUSA
  2. 2.Department of PsychiatryUniversity of MinnesotaSt. PaulUSA
  3. 3.Department of Family Social ScienceUniversity of MinnesotaSt. PaulUSA
  4. 4.The Family InstituteNorthwestern UniversityEvanstonUSA

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