A Program for Training Teachers as Counselors of Parents of Children with Disabilities

The author presents a four-session, in-service training program in which a counselor serves as facilitator. The focus of the program is training teachers to work more effectively with parents of children with disabilities through the integration of counseling theory and special education practice.     

Parent Training for Childhood Anxiety Disorders: The SPACE Program

Anxiety disorders are the most prevalent disorders of childhood and adolescence. Cognitive behavioral therapy (CBT) for anxiety poses a challenge for clinicians as it requires active client participation, and many children either decline or do not adequately comply with treatment. In addition, even after treatment with CBT, up to 50% of children remain symptomatic, and many still meet diagnostic criteria. Parent-directed clinical work has been advocated as a potential enhancer of treatment outcomes, and exclusively parent-based interventions might replace child treatment when the child is reluctant. However, parent involvement has yet to be shown to significantly improve outcomes, relative to child-only therapy. Studies so far have focused mainly on including parents in children’s therapy, training parents as lay therapists, or teaching parenting skills. Parent training focused on parental behaviors specific to childhood anxiety, such as family accommodation, may be more effective. In this treatment development report we present the theoretical foundation, structure, and strategies of a novel parent-based intervention for childhood anxiety disorders. We will also present the results of an open trial of the treatment, with an emphasis on feasibility, acceptability, and initial outcomes. Participants in the trial were parents of 10 children, aged 9 to 13. Children had declined individual child treatment. Multiple excerpts from the treatment manual are included with the hope of “bringing the treatment to life” and conveying a rich sense of the therapeutic process. Parents participated in 10 weekly sessions. Significant improvement was reported in child anxiety and family accommodation as well as in the child’s motivation for individual treatment. No parents dropped out and satisfaction was high. The SPACE Program (Supportive Parenting for Anxious Childhood Emotions) is a novel, manualized parent-based intervention that is feasible and acceptable and may be effective in improving childhood anxiety.     

A Meta-analytic Review of Components Associated with Parent Training Program Effectiveness

This component analysis used meta-analytic techniques to synthesize the results of 77 published evaluations of parent training programs (i.e., programs that included the active acquisition of parenting skills) to enhance behavior and adjustment in children aged 0-7. Characteristics of program content and delivery method were used to predict effect sizes on measures of parenting behaviors and children's externalizing behavior. After controlling for differences attributable to research design, program components consistently associated with larger effects included increasing positive parent-child interactions and emotional communication skills, teaching parents to use time out and the importance of parenting consistency, and requiring parents to practice new skills with their children during parent training sessions. Program components consistently associated with smaller effects included teaching parents problem solving; teaching parents to promote children's cognitive, academic, or social skills; and providing other, additional services. The results have implications for selection and strengthening of existing parent training programs.     

Evaluating Triple P Online: A Digital Parent Training Program for Child Behavior Problems

Triple P Online (i.e., TPOL; www2.tripleponline.net) is an online self-help parent training program aimed at reducing child behavior problems through “positive parenting practices”—available at time of review for $79.95. TPOL is comprised of 8 video-based modules that also incorporate in-session activities and homework. Randomized control trials have shown that TPOL effectively reduces child behavior problems. The program’s main strengths include very high-quality content with an abundance of relevant and easily locatable resources, an easy-to-use interface, and a professional look and feel. The program’s main weakness lies in its lack of monitoring and adaptation to the user’s state (e.g., child’s and parent’s behaviors), and real-time reminders for desired actions. Altogether, TPOL is an extremely valuable and important resource for families seeking evidence-based treatment for child behavior problems.     

Counseling and Human Sexuality: A Training Model

In recent years sexuality has been broadly defined as a fundamental dimension of personality. Mental health practitioners need to respond to the increased awareness of human sexuality as a vital aspect of personal development. To date, few programs or workshops assist mental health counselors in developing the necessary skills to confront sexual concerns in the counseling relationship. This article presents a counseling and human sexuality course model that provides counselors with an information base in human sexuality and assists them in exploring the emotional aspects of sexuality. This course model assumes that mental health counselors will provide a valuable service to their client populations once they have become more willing and able to explore sexual conflicts.     

Behavioral Parent Training:

Parents of 42 conduct disordered children were randomly allocated to either contingency management training, communication skills training or a waiting list control condition. The two treatments were conducted with the problem child either present or absent during sessions. Assessment devices included the Behavior Problem Checklist, Becker Adjective Checklist, Parent Attitude Survey, Piers-Harris Self-Concept Scale, and Daily observations made by parents. In comparison to waiting list controls, significant treatment effects were found on the Behavior Problem Checklist and on one attitude subscale (Understanding). More subjects in the contingency management condition met a criterion of clinical success than in the other conditions. No differential effect was associated with the conduct of treatment under conditions where the child was either present of absent form the sessions.     

Empowering Parents: The Use of the Parent as Researcher Paradigm in Early Intervention

Whilst family-focussed models of service delivery are proving more effective in early intervention, it is the parents who ultimately carry the burden of responsibility. They often evolve their own strategies for coping with difficulties and solving problems within a family context. Through case study analysis, I report on some of the key outcomes of early intervention for families of very young children with disabilities. The analysis challenges traditional definitions of the family and suggests a recontextualisation of this concept. Similarly parental perceptions of the style of early intervention services are contrasted with those models reported to be effective by professionals. In striving for optimal effectiveness in early intervention, the unique knowledge and understanding of parents is pivotal, and ways are suggested of objectively collecting and collating that knowledge to inform practice and identify important research questions. This case study analysis has led to the evolution of the parent as researcher paradigm, and the implications for the practical implementation of this model will be considered.     

Reaching Latino Families Through Pediatric Primary Care: Outcomes of the CANNE Parent Training Program

The lack of culturally adapted parenting programs for Latinos contributes to low engagement in effective parenting programs. Criando a Nuestros Niños Hacio el Éxito (CANNE), a culturally adapted program, improves family dynamics by decreasing problematic child behavior and helping parents manage stress. CANNE was delivered with 12 Latino parents of children (age 3–7). Increased attendance and participation resulted in less child behavior problems and parenting stress from preintervention to postintervention. A culturally relevant adaptation of an evidence-based parenting program improved engagement, child behavioral outcomes, and parenting stress. Implications of mental health services in primary care facilities for Latino families are addressed.     

Training Community Members to Serve as Paraprofessionals in an Evidence-Based,Prevention Program for Parents of Preschoolers

Widespread dissemination of evidence-based programs for underserved populations may require non-traditional means of service provision. Collaboration with paraprofessionals from communities that are targeted for intervention holds promise as a delivery strategy that may make programs more accessible and acceptable, especially to parents living in low-income, urban neighborhoods. We describe a paraprofessional training program for individuals living in a community targeted for preventive intervention based on high levels of poverty and community violence. The design and implementation of the training program are described in the context of issues related to the use of paraprofessionals in community-based, preventive interventions with parents of young children. We also provide insight into lessons learned from a feasibility study as well as general guidelines for the development of paraprofessional training programs for delivery of evidence-based programs.     

Dialectical Behavior Therapy Applied to Parent Skills Training: Adjunctive Treatment for Parents With Difficulties in Affect Regulation

Poor outcomes in parent training programs have been associated with parental psychopathology in general, and difficulties in parental affect regulation in particular. Although many parents may be able to learn behavioral management skills in a controlled therapy setting, for those who experience affect dysregulation, generalization of these skills to the natural environment may be challenging when their emotions are aroused. Parents, particularly those who struggle with affect dysregulation around their child's behavior, may benefit from dialectical behavior therapy (DBT) because it specifically targets problems in emotion regulation. Thus, the purpose of this article is to discuss relevant aspects of DBT (e.g., dialectics, biosocial model, and validation) and highlight its applicability to parents who struggle with affect dysregulation. Several clinical case studies will also be presented to elucidate how mental health professionals can address the affect dysregulation in parents by teaching them DBT skills to manage their own negative emotions, particularly when their child's behavior is the source of emotional arousal.     

Parent Training with Non-Traditional Families:

Although behavioral parent training has been shown to be effective with a variety of child behavior problems, this review notes that the adaptation and generalization of this treatment across family populations has not met with consistent success. The therapeutic need of families with diverse backgrounds and those facing interpersonal and intra-familial conflicts only recently has been raised by therapists. To promote effective and generalized treatment success across this population, some therapists recommend adjunctive or alternative treatment strategies that encompass the specific needs and characteristic make-up of a family. Several of the recommended adaptations that have been made are described in this review. Despite the therapeutic merit of many of these recommendations, it is concluded that little empirical information currently exists on the implementation of the various treatment adaptations. Recommendations are made to evaluate further clinical issues related to the needs of non-traditional and other non-middle class families.     

Modeling the Bullying Prevention Program Preferences of Educators: A Discrete Choice Conjoint Experiment

We used discrete choice conjoint analysis to model the bullying prevention program preferences of educators. Using themes from computerized decision support lab focus groups (n = 45 educators), we composed 20 three-level bullying prevention program design attributes. Each of 1,176 educators completed 25 choice tasks presenting experimentally varied combinations of the study’s attribute levels. Latent class analysis yielded three segments with different preferences. Decision Sensitive educators (31%) preferred that individual schools select bullying prevention programs. In contrast, Support Sensitive educators (51%) preferred that local school boards chose bullying prevention programs. This segment preferred more logistical and social support at every stage of the adoption, training, implementation, and long term maintenance processes. Cost Sensitive educators (16%) showed a stronger preference for programs minimizing costs, training, and implementation time demands. They felt prevention programs were less effective and that the time and space in the curriculum for bullying prevention was less adequate. They were less likely to believe that bullying prevention was their responsibility and more likely to agree that prevention was the responsibility of parents. All segments preferred programs supported by the anecdotal reports of colleagues from other schools rather than those based on scientific evidence. To ensure that the bullying prevention options available reflect the complex combination of attributes influencing real world adoption decisions, program developers need to accommodate the differing views of the Decision, Support, and Cost Sensitive segments while maximizing the support of parents and students.