Abstract
Disruptive behavior disorders (DBD) in children can lead to delinquency in adolescence and antisocial behavior in adulthood. Several evidence-based behavioral parent training (BPT) programs have been created to treat early onset DBD. This paper focuses on one such program, helping the noncompliant child (HNC), and provides detailed cost estimates from a recently completed pilot study for the HNC program. The study also assesses the average cost-effectiveness of the HNC program by combining program cost estimates with data on improvements in child participants’ disruptive behavior. The cost and effectiveness estimates are based on implementation of HNC with low-income families. Investigators developed a Microsoft Excel-based costing instrument to collect data from therapists on their time spent delivering the HNC program. The instrument was designed using an activity-based costing approach, where each therapist reported program time by family, by date, and for each skill that the family was working to master. Combining labor and non-labor costs, it is estimated that delivering the HNC program costs an average of $501 per family from a payer perspective. It also costs an average of $13 to improve the Eyberg Child Behavior Inventory intensity score by 1-point for children whose families participated in the HNC pilot program. The cost of delivering the HNC program appears to compare favorably with the costs of similar BPT programs. These cost estimates are the first to be collected systematically and prospectively for HNC. Program managers may use these estimates to plan for the resources needed to fully implement HNC.
Similar content being viewed by others
References
Brinkmeyer, M., & Eyberg, S. M. (2003). Parent-child interaction therapy for oppositional children. In A. E. Kadzin & J. R. Weisz (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 20–223). New York, NY: Guilford.
Cohen, M. A. (1998). The monetary value of saving a high risk youth. Journal of Quantitative Criminology, 4, 5–33.
Edwards, R. T., Ceilleachair, A., Bywater, T., Hughes, D. A., & Hutchings, J. (2007). Parenting programme for parents of children at risk of developing conduct disorder: Cost effectiveness analysis. British Medical Journal, 334, 682–687.
Eyberg, S. M., Boggs, S. R., & Algina, J. (1995). Parent-child interaction therapy: A psychosocial model for the treatment of young children with conduct problem behavior and their families. Psychopharmacology Bulletin, 31, 83–91.
Eyberg, S., Funderburk, B., McNeil, C., Querido, J., & Hood, K. (2001). Parent-child interaction therapy with behavior problem children: One and two year maintenance of treatment effects in the family. Child and Family Behavior Therapy, 23, 1–20.
Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 37, 215–237.
Eyberg, S. M., & Pincus, D. (1999). Eyberg child behavior inventory & Sutter-Eyberg student behavior inventory-revised: Professional manual. Odessa, FL: Psychological Assessment Resources.
Fenwich, E., & Byford, S. (2005). A guide to cost-effectiveness acceptability curves. British Journal of Psychiatry, 18, 106–108.
Foster, E. M., & Jones, D. E. (2005). The high costs of aggression: Public expenditures resulting from conduct disorder. American Journal of Public Health, 95, 1767–1772.
Foster, E. M., Olchowski, A. E., & Webster-Stratton, C. H. (2007). Is stacking intervention components cost-effective? An analysis of the incredible years program. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1414–1424.
Glick, H. A., Doshi, J. A., Sonnad, S. S., & Polsky, D. (2007). Economic evaluation in clinical trials. New York, NY: Oxford University Press.
Goldfine, M. E., Wagner, S. M., Branstetter, S. A., & McNeil, C. B. (2008). Parent-child interaction therapy: An examination of cost-effectiveness. Journal of Early and Intensive Behavior Intervention, 5, 119–141.
Hutchings, J., Gardner, F., Bywater, T., Daley, D., Whitaker, C., Jones, K., et al. (2007). Parenting intervention in sure start services for children at risk of developing conduct disorder: Pragmatic randomised controlled trial. British Medical Journal, 334, 678–693.
Ingoldsby, E. M. (2010). Review of interventions to improve family engagement and retention in parent and child mental health programs. Journal of Child and Family Studies, 19, 629–645.
Jones, K., Daley, D., Hutchings, J., Bywater, T., & Eames, C. (2008). Efficacy of the Incredible Years Programme as an early intervention for children with conduct problems and ADHD: Long-term follow-up. Child: Care, Health and Development, 34, 380–390.
Jones, D. J., Forehand, R., Cuellar, J., Kincaid, C., Parent, J., Fenton, N., et al. (2013). Harnessing innovative technologies to advance children’s mental health behavioral parent training as an example. Clinical Psychology Review, 33, 241–252.
Jones, D. J., Forehand, R., Cuellar, J., Parent, J., Honeycutt, A., Khavjou, O., Gonzalez, M., Anton, M., & Newey, G. (in press). Development and pilot evaluation of a technology- enhanced behavioral parent training program for children’s disruptive behavior disorders. Journal of Clinical Child and Adolescent Psychology.
Kazak, A. E., Hoagwood, K., Weisz, J. R., Hood, K., Kratochwill, T. R., Vargas, L. A., et al. (2010). A meta-systems approach to evidence-based practice for children and adolescents. American Psychologist, 65, 85–97.
Long, P., Forehand, R., Wierson, M., & Morgan, A. (1994). Does parent training with young noncompliant children have long-term effects? Behaviour Research and Therapy, 32, 101–107.
McMahon, R. J., & Forehand, R. (2003). Helping the noncompliant child: Family-based treatment for oppositional behavior (2nd ed.). New York, NY: Guilford Press.
O’Neill, D., McGilloway, S., Donnelly, M., Bywater, T., & Kelly, P. (2013). A cost-effectiveness analysis of the incredible years parenting programme in reducing childhood health inequalities. European Journal of Health Economics, 14, 85–94.
Piquero, A. R., Farrington, D. P., Welsh, B. C., Tremblay, R., & Jennings, W. G. (2009). Effects of early family/parent training programs on antisocial behavior and delinquency. Journal of Experimental Criminology, 5, 83–120.
Reitman, D., & McMahon, R. J. (2013). Constance “Connie” Hanf (1917–2002): The mentor and the model. Cognitive and Behavioral Practice, 20, 106–116.
Sanders, M. R. (2008). Triple P-positive parenting program as a public health approach to strengthening parenting. Journal of Family Psychology, 22, 506–517.
Sanders, M. R., Markie-Dadds, C., Tully, L. A., & Bor, W. (2000). The triple P-positive parenting program: A comparison of enhanced, standard, and self-directed behavioral family intervention for parents of children with early onset conduct problems. Journal of Consulting and Clinical Psychology, 68, 624–640.
Scott, S., Knapp, M., Henderson, J., & Maughan, B. (2001). Financial cost of social exclusion: Follow up study of antisocial children into adulthood. British Medical Journal, 323, 191–195.
Webster-Stratton, C., & Hancock, L. (1998). Training for parents of young children with conduct problems: Content, methods, and therapeutic processes. In C. E. Schaefer & J. M. Briesmeister (Eds.), Handbook of parent training. New York, NY: Wiley.
Conflict of interest
There are no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Honeycutt, A.A., Khavjou, O.A., Jones, D.J. et al. Helping the Noncompliant Child: An Assessment of Program Costs and Cost-Effectiveness. J Child Fam Stud 24, 499–504 (2015). https://doi.org/10.1007/s10826-013-9862-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-013-9862-7