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Two-Year Findings from a National Effectiveness Trial: Effectiveness of Behavioral and Non-Behavioral Parenting Programs

Abstract

Long-term follow-up studies of selective parent training (PT) programs are scarce, particularly in the case of effectiveness trials conducted within regular care settings. This study evaluated the 2-year effects of 4 programs: Comet, Incredible Years, Cope, and Connect and differences in the rate of change among programs were investigated using Latent Growth Modeling (LGM). Participants were parents who had sought help at 30 local service sector units (e.g., child psychiatric clinics and social services centers) for major problems in managing their children’s externalizing behavior. Parents of 749 children (63 % boys) with moderate levels of externalizing behavior, aged 3–12, were randomized to one of the 4 PT programs. Assessments included parent-reported measures of child externalizing, hyperactivity and inattention, as well as parenting practices, sense of competence, and parents’ stress and depressive symptoms. At 2-year follow-up, there were no differences in any of the child outcomes among the programs. All programs had reduced externalizing behaviors with large effect sizes (d = 1.21 to d = 1.32), and negative parenting practices with moderate to large effect sizes (d = 0.49 to d = 0.83). LGM analyses showed that the 2 behavioral programs, Comet and Incredible Years, produced more rapid reductions in externalizing behavior during the course of the intervention than the non-behavioral program, Connect. Connect, however, was the only program where children continued to improve after the intervention. Overall, the results indicate that the 4 programs were equally effective in a clinical setting, despite differences in their theoretical origin.

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Acknowledgments

We thank the National Board of Health and Welfare in Sweden who funded this trial and we would also like to express our deepest gratitude to the families, care units and group leaders that participated in the study.

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Correspondence to Jens Högström.

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Funding

This study was funded by the National Board of Health and Welfare (Socialstyrelsen) in Sweden, grant number 01–12,042/2008.

Conflict of Interest

Author Jens Högström declares that he has no conflict of interest. Author Viveca Olofsson declares that she has no conflict of interest. Author Metin Özdemir declares that he has no conflict of interest. Author Pia Enebrink declares that she has no conflict of interest. Author Håkan Stattin declares that he has no conflict of interest.

Ethical Approval

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.

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

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Supplementary material 1 Means and standard deviations of all outcome measures (DOCX 26 kb)

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Supplementary material 2 Correlations among study variables at baseline (DOCX 17 kb)

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Högström, J., Olofsson, V., Özdemir, M. et al. Two-Year Findings from a National Effectiveness Trial: Effectiveness of Behavioral and Non-Behavioral Parenting Programs. J Abnorm Child Psychol 45, 527–542 (2017). https://doi.org/10.1007/s10802-016-0178-0

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  • DOI: https://doi.org/10.1007/s10802-016-0178-0

Keywords

  • Parent training programs
  • Externalizing behavior
  • Long-term follow-up
  • Effectiveness
  • Randomized controlled trial