Incredible Years: Parent Training
BACKGROUND: Despite recognition of the need to deliver evidence-based programmes in the field of mental health, there is little emphasis on implementing such programmes with fidelity. Attempts by programme developers to ensure adherence to their programmes include the development of training, manuals and content scales, but these alone may be insufficient to ensure fidelity in replication. Observational measures lend themselves as a potentially useful assessment of intervention outcomes, providing accurate and objective accounts of the intervention process.
AIM: To develop a reliable and valid observational treatment fidelity tool of process skills required to deliver the Incredible Years (IY) BASIC parenting programme effectively. Methods An objective observational fidelity measure was developed to assess adherence to the IY BASIC parenting programme protocol. Observations were conducted on 12 IY BASIC parenting programme groups, attended by parents of pre-school children displaying signs of early onset conduct disorder.
RESULTS: The Leader Observation Tool (LOT) achieved high internal reliability and good code?recode and inter-rater reliability. Evidence of concurrent validity was also obtained. Conclusions Having demonstrated that the LOT is a reliable and valid measure of implementation fidelity, further research is necessary to examine the relationship between LOT scores and intervention outcome.
A recent UK government-commissioned report on early intervention stated that ?what parents do is more important than who they are? (Allen, 2011, p. xiv). The report emphasised the importance of support for families at disadvantage at an early age before behavioural and social problems become entrenched and more expensive to tackle. Children classified as securely attached in the first 12 to 18 months develop better peer relationships at pre-school (Sroufre, Fox, & Pankake, 1983) and achieve better academic outcomes (Pearson et al., 2011).
The increased emphasis on investing support for families before children enter school has increased the need for assessment tools that support and encourage positive parenting. Identifying the positive parental behaviours that promote healthy child development is challenging as many of the current observational codes have been designed for parents? interactions with older children. This article describes the development of a new observational code to analyse the behaviour of mothers playing with their baby in the first 18 months. The six predetermined positive parenting behaviours are analysed using video recordings from the home. Practitioners can be trained to use the code and a manual facilitates future researchers and clinicians to evaluate parent behaviour with their infant in a natural environment and with minimal disturbance to the family.
Findings suggest that there is an important need to develop multifaceted parent training programs that not only teach more positive parent skills but also incorporate stress management and interpersonal relationship skills, as well as a need for social support, especially for single and martially distressed parents.
Head Start centers were randomly assigned to intervention (parent training) or control conditions, and the role of maternal mental health risk factors on participation in and benefit from parent training was examined. Parenting was measured by parent report and independent observation in 3 domains: harsh/negative, supportive/positive, inconsistent/ineffective parenting. Structural equation modeling showed that parent engagement training was associated with improved parenting in a dose-response fashion. Mothers with mental health risk factors (i.e., depression, anger, history of abuse as a child, and substance abuse) exhibited poorer parenting than mothers without these risk factors. However, mothers with risk factors were engaged in and benefited from the parenting training program at levels that were comparable to mothers without these risk factors.
This study examines the role of several components of parental stress in physically abusive and nonabusive families with conduct-disordered children. The 123 families studied were seen in a parenting clinic aimed at improving parent-child interactions in families with a highly oppositional child. Parent stress was found to play in important role in abusive families. Physically abusive families were significantly more often low income, had younger mothers with less education, more frequently reported a family history of child abuse, and were more likely to be abusing alcohol or drugs.
This What Works Brief is part of a continuing series of short, easy-to-read, ‘how to’ information packets on a variety of evidence-based practices, strategies, and intervention procedures. The Briefs are designed to help teachers and other caregivers support young children?s social and emotional development. In-service providers and others who conduct staff development activities should find them especially useful in sharing information with professionals and parents. The Briefs include examples and vignettes that illustrate how practical strategies might be used in a variety of early childhood settings and home environments.
La funci?n del ?tiempo de descanso? como uno de los m?todos para tratar los comportamientos desafiantes de ni?os preescolares
Read the article (Spanish) (PDF)
ABSTRACT: This study examined the perceived effectiveness, acceptability, and integrity of the self-administered format of the Incredible Years Parent Training Program, for children exhibiting behaviors associated with attention-deficit/hyperactivity disorder. To assess perceived effectiveness, an AB pretest-posttest design was used across 10 weeks. Improvements in parents’ rating of adaptive skills were replicated across five participants.
A powerpoint presentation of a study in Portugal with control group evaluating IY parent program. And a research poster of the study.
Location: Centro de Psicopedadogia, a research Centre based at the Faculty of Psychology and Educational Sciences of the University of Coimbra, Portugal.
History: In October 2003 a team had the first training in the delivery of the IY Basic with an US trainer at the Centro de Psicopedagogia.
Translation and adaptation to Portuguese of all the IY Basic materials (including the DVD?s sub-titles and the translation of the manual and of the book for parents).
In 2007 the first IY Basic group was delivered by the two authors.
One of the advantages of the Incredible Years (IY) Parent Training Program is that it can be tailored to meet the needs of parents from varying cultural backgrounds and to address the individual goals and values for each family and child. In numerous randomized control group studies, the IY Parent Program has been shown to effectively promote positive and nurturing parenting interactions, to reduce critical and harsh parenting and to reduce behavior problems in high risk children (Webster-Stratton and Reid 2003). The program has also been shown to be effective with parents of different racial and cultural backgrounds (Reid, Webster-Stratton et al. 2001). In particular, the program has been shown to promote positive parenting in African American, Chinese American, Asian American, and Hispanic parents ((Reid, Webster-Stratton et al. 2001; Webster-Stratton, Reid et al. 2001). Other investigators have replicated these findings with African American families (Gross, Fogg et al. 2003; Miller Brotman, Klein et al. 2003), Hispanic families (Barrera, Biglan et al. 2002), Korean families (Kim, E. unpublished manuscript) and multi-ethnic families in England (Scott, Spender et al. 2001).
Bringing the IY parenting programs to parents who speak different languages and who represent different cultural backgrounds is a special privilege and opportunity because of the rich diversity of the individuals in the groups and the chance for these families to learn from each other and build support networks. To deliver this program to parents who don’t speak English, it is necessary to partner with interpreters who share the linguistic and cultural backgrounds of the parents. We begin this partnership by offering joint interpreters and parent group leaders’ training workshops. In this training, group leaders learn about the values, parenting beliefs, and unique problems of each culture while interpreters learn about child development principles, relationship skills, and behavior change strategies as well as the IY parenting program content and methods. Two videotapes of parent groups showing group leaders working with interpreters representing four different languages form the basis for these discussions.
The article is based on transcripts of workshops between Dr. Carolyn Webster-Stratton, several English speaking IY parent group leaders and interpreters representing the following countries: Ethiopia (Amharic, Arabic, Tigrinya, Oromo), China, Vietnam, Somalia, and Mexico. The article begins with a discussion of the special issues and problems for new immigrant families. This information forms the background context for introducing the IY parent program and for addressing the goals that will be relevant for these families. Next principles of effective interpreting for the IY program and for training interpreters are reviewed. The final section includes program evaluation by interpreters after they have delivered the program in collaboration with a group leader.
La incidencia del trastorno oposicionista desafiante (TOD) y el trastorno disocial (TD) (conduct disorder) en ni?os es alarmantemente alta, con informes de inicio temprano de problemas de conducta en ni?os preescolares en tasas que van del 4-6% y tanto como un 35% para las familias de bajos ingresos.
AbstractAn increasing body of research identifies the long-term impact and health harm that can.
Objective – To determine if a nurse-led or psychologist-led parent-training program was more successful than a minimal intervention in treating early childhood Oppositional Defiant Disorder (ODD) in pediatric primary care.
The present study compared three models of intervention: an office model, with primary care nurses providing a moderately intensive parent training program; a referral model, with clinical child psychologists providing the same parent training, and a minimal intervention treatment without therapist contact. The Webster-Stratton parent training program we used has considerable empirical support and its videotape-based program seemed suitable for use by nonmental health professionals.
The current study aims to investigate if LOT skills subgroups predict change in parenting behaviour, for parents with preschool children at risk of developing CD who attended IY PT groups within Sure Start areas in North and MidWales and the borders (see Hutchings et al. 2007 for full details of the trial). The hypotheses are twofold. First, it is predicted that greater exposure will produce greater change in observed positive parenting behaviours and change in self-reported parenting style. Second, it is hypothesized that observed change in positive parenting will predict change in observed child outcome scores, and change in parent-reported parenting style will predict change in parent-reported child behaviour problems.
Background: Change in parenting skills, particularly increased positive parenting, has been identified as the key component of successful evidence-based parent training (PT), playing a causal role in subsequent child behaviour change for both prevention and treatment of Conduct Disorder. The amount of change in parenting skills observed after PT varies and may be accounted for by both the content of the programme and by the level of PT implementer process skills. Such variation in implementer skills is an important component in the assessment of treatment fidelity, itself an essential factor in successful intervention outcome.
Aims: To establish whether the Leader Observation Tool, a reliable and valid process skills fidelity measure, can predict change in parenting skills after attendance on the Incredible Years PT programme.
Results: Positive leader skills categories of the Leader Observation Tool significantly predicted change in both parent-reported and independently observed parenting skills behaviour, which in turn, predicted change in child behaviour outcome.
Conclusions: Delivering an intervention with a high level of treatment fidelity not only preserves the behaviour change mechanisms of the intervention, but can also predict parental behaviour change, which itself predicts child behaviour change as a result of treatment.
Abstract – The efficacy of the Incredible Years parent training and child therapy programs was examined in a randomized controlled study including 127 Norwegian children aged 4?8 years. Children diagnosed with oppositional defiant disorder (ODD) or conduct disorder (CD) were randomized to parent training (PT), parent training combined with child therapy (PT + CT), or a waiting-list control condition (WLC). Assessments were carried out at baseline, posttreatment and at a one-year follow-up using standardized measures and a semi-structured interview. Both active treatment conditions reduced child conduct problems posttreatment as opposed to the WLC, while differences between the two treatment conditions were small and nonsignificant. About two thirds of the treated children functioned within normal variation after treatment, and the same proportion no longer received an ODD diagnosis at the one-year follow-up. Parental use of positive strategies increased after treatment, and the use of harsh and inconsistent discipline decreased as did mother experience of stress. The outcome of this study emphasizes the importance of offering parent training to young children with severe conduct problems exhibited at home. The findings and usefulness of the Incredible Years program in the present Norwegian replication study further support and extend positive outcomes of previous controlled trials conducted primarily in Anglo-Saxon ountries.
There is a rather large body of literature describing the content of parent training programs. For example, strategies such as Time Out, Beta Commands, Praise, Differential Attention, Response Cost, and so on, along with the behavioral principles that underlie them, have been carefully described in detail. But descriptions of the content of parent training do not elucidate the mechanisms or ongoing processes of parent training-that is, the processes and strategies which therapists can use to try to change or modify parents; behaviors, attitudes, and practices- and the literature contains comparatively little discussion of the actual therapeutic processes utilized by therapists in such intervention programs.
Read the Book Chapter (PDF) (3.4MB)
In this chapter, we present a number of questions and objections which parents frequently raise when we are discussing the various content areas. In raising htese issues and offering some explanations we might use in our groups, our intention is to help therapists prepare for the nature of parent discussions. If parents do not raise these questions, out of reluctance or for some other reason, we suggest that the therapist raise these issues him/herself in order to foster problem-solving and discussion.
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This paper has three general aims. The first is to review briefly some of the current research on performance-training methods so as to provide evidence of the benefit of using videotape modeling for parent training. The second aim is to describe the guidelines for developing and using a videotape modeling program. The third aim is to describe the content of one such program which was developed and researched by the author at the University of Washington.
From 2007-2009 the Washington State Child Welfare office has funded the training of family support workers and delivery of the evidence-based Incredible Years parenting program to families who had been referred to them for child abuse and neglect. Most of these families were classified as open cases and the program was highly recommended to them while other families were mandated to take the program. A total of 15 separate groups were offered throughout Snohomish, Whatcom, and Skagit counties with the average size of parent groups ranging from 10-19 participants.
Parents completed baseline measures and post-treatment assessments of parenting stress and child behavior problems. After treatment parents also completed program evaluations. These measures are described in this report.
AbstractThe aim of the present study was to investigate residential child care staff satisfaction with.
Ensuring that a child is brought up experiencing warmth, love and encouragement within safe boundaries is far harder for parents who live in the stressful conditions found in poor neighbourhoods. Children raised in poverty do less well than children raised in more favourable circumstances on a range of measures of attainment and quality of life. Yet, if the emotional quality of a child?s upbringing is good, then the evidence is clear that children can succeed despite starting in less favourable conditions. This report describes an evaluation of what factors make an intervention effective in helping parents in one of the poorest parts of Britain give their children a better start in life.
This study investigated the factors that affect the impact of an intervention programme for parents of five and six year olds, and was called the Primary Age Learning Study (PALS). The aims of this study continue the tradition of other studies published by the Joseph Rowntree Foundation (JRF) on related topics, including recently Routes out of Poverty: A Research Review (Kemp et al. , 2004), Migration and Mobility: The Life Chances of Britain?s Minority Ethnic Communities (Platt, 2005) and Anti-social Behaviour Strategies: Finding a Balance (Millie et al. , 2005). However, while most JRF studies are observational, this study is one of the few that is an evaluation of an intervention; for example, it follows the evaluation of three ?Communities that Care? demonstration projects (Crow et al ., 2004). It is only the second we know of that is a randomised controlled trial, which is by far the surest way to determine effectiveness; the other was the study of the outcomes and costs of Home-Start support for young families under stress (McAuley et al. , 2004). The support given in Home-Start was very well received by parents, although it did not show any impact on parenting or child outcomes during the time period of the study.
The need to help families with conduct-disordered children is particularly urgent, for these “aggressive” children are at increased risk for being abused by their parents, as well as for school dropout, alcoholism, drug abuse, juvenile delinquency, adult crime, antisocial personality, marital disruption, interpersonal problems, and poor physical health. Thus in the absence of treatment, the long-term outlook for conduct-problem children is poor.
There is a modest but growing literature in the parenting field, based on secondary analysis of randomized trials suggesting that change in observed positive parenting skill may be an important predictor of change in child outcome. Furthermore, several studies suggest that, at least in early childhood, positive rather than negative parenting may be a developmentally more important predictor of child problem behavior outcome, based on converging evidence from both randomized intervention trials and longitudinal studies of natural development. We chose to focus on overt parenting skill as a postulated intervention mechanism, because this is consistent with the theoretical underpinnings of cognitive-behavioral parenting interventions, which assume that parenting skill is the primary mechanism underlying both development and change in children?s conduct problems.