Early impact of the BEST intervention for parents stressed by adolescent substance abuse

Youth involvement in substance abuse can be a source of considerable distress for their parents. Unilateral family interventions have been advocated as one means by which concerned family members can be supported to assist substance‐abusing family members. To date there has been little research examining the impact of unilateral family interventions on the directly participating family members. In this study the early impact of an 8‐week parent‐group programme known as Behavioural Exchange Systems Training (BEST) was evaluated using a quasi‐experimental, waiting list control design. The professionally led programme had been developed to support and assist parents in their efforts to cope with adolescent substance abuse. Subjects were 66 parents (48 families) accepted for entry into the programme between 1997 and 1998. Comparison was made between 46 parents offered immediate entry into the programme and 20 parents whose entry to the programme was delayed by an 8‐week waiting list. At the first assessment 87% of parents showed elevated mental health symptoms on the General Health Questionnaire. Evidence suggested exposure to the intervention had a positive impact on parents. Compared to parents on the waiting list, parents entered immediately into the intervention demonstrated greater reductions in mental health symptoms, increased parental satisfaction, and increased use of assertive parenting behaviours. Copyright © 2001 John Wiley & Sons, Ltd.     

A Child Trauma Treatment Pilot Study

We examined outcomes of a promising 21-session trauma treatment model for children aged 3 to 17 and their caregivers. All children in treatment had experienced at least one traumatic event. The treatment intervention was rooted in theories of trauma and attachment and combines parent training with cognitive behavioral therapy to form a comprehensive trauma treatment program. We report on 27 families who completed the program. Results reflect significant reductions in conduct disorder, problems in social relations, and caregiver depression at an average of a one-year post-treatment follow-up. Results from our preliminary study offer support for further evaluation of the model.     

Parent Expectancies for Child Therapy: Assessment and Relation to Participation in Treatment

Two studies examined parents' pre-treatment expectancies for their child's psychotherapy among children (N = 405, ages 2–15) referred for oppositional, aggressive, and antisocial behavior. Study I focused on the development of a measure to assess expectancies. The results indicated that the measure was internally consistent. Moreover, socioeconomic disadvantage and ethnic minority status, severity of child dysfunction, child age, and parental stress and depression were significant predictors of lower parent expectancies for child therapy. Study II examined the relation of parent expectancies and participation in therapy. The results indicated that parent expectancies predicted subsequent barriers to treatment participation, treatment attendance, and premature termination from therapy. Overall, these findings have implications for the study of expectancies for therapy, for identifying families at risk for premature termination from treatment, and for the development of interventions designed to increase parent participation in child therapy.     

Reducing Parent Distress and Increasing Parent Coping-Promoting Behavior During Children's Medical Procedure

The study investigated whether involving parents in their child's cognitive-behavioral intervention would effectively reduce parent distress during their child's medical procedure. Parents participating with their 3- to 7-year-old children prior to a voiding cystourethrogram were randomly assigned to an intervention (N = 20) or a standard care (N = 20) condition. The intervention included provision of information, coping skills training, and parent coaching. Parents participating in the intervention had a significant reduction in anxiety following the intervention relative to parents in standard care. Trained parents displayed fewer distress-promoting and more coping-promoting behaviors during the procedure, even though parents in both conditions reported similar levels of anxiety during the procedure. Involving parents in children's interventions is crucial to reduce parent distress and prepare parents to assist their child during the medical procedure.     

Maternal perception of infant intentionality at 4 and 8 months

This study examines the degree to which mothers perceive infants as intentional and the relations among perception of intentionality, background variables, maternal emotional adjustment, and maternal interactive style. Forty mother-infant dyads were assessed when the infants were 4 months old, and 34 were retested at 8 months. Parent perception of infant intentionality (PPII) was measured via a rating of videotaped segments of infant behavior and an interview. Intentionality scores showed acceptable internal consistency and were positively intercorrelated at each age and across age. The two measures were aggregated to form an index of PPII at each age. Higher educational attainment was associated with lower PPII scores, experience with infants was associated with higher PPII scores, and academic knowledge about child development was not related to PPII. Mothers with more symptoms of anxiety had lower PPII scores, but high maternal separation anxiety was associated with higher PPII scores. Maternal symptoms of depression had a complex relation to PPII scores. Mothers rated as sensitive in mother-infant interactions had higher PPII scores. These variables accounted for 34% of the variance in PPII at 4 months and 49% at 8 months. There were also group differences: Mothers of 8-month-olds had higher PPII scores than mothers of 4-month-olds, mothers of girls had higher PPII scores than mothers of boys, and mothers attributed more intentionality in episodes with girls than in episodes with boys. The results are discussed in relation to mechanisms whereby PPII interacts with aspects of the parent and infant.     

Prevention of Child Maltreatment: Evaluation of a Parent Education Program for Teen Mothers

We conducted an evaluation of a parent education program for the prevention of child maltreatment that served urban teen, unmarried mothers at risk for child maltreatment. Three to five years after the birth of their children, program graduates (n = 125) were significantly less likely than controls (n = 410) to have founded reports of maltreatment in the state database. On the basis of a follow-up phone call to a subset of 80 program graduates and 40 controls, mothers who enrolled in the 12-week parent education/support program showed trends toward being more likely to have completed high school, taken some college courses, and delayed subsequent pregnancies until after age 21.     

Norms for Parental Ratings on Conners' Abbreviated Parent-Teacher Questionnaire: Implications for the Design of Behavioral Rating Inventories and Analyses of Data Derived from Them

Despite the wide usage of Conners' 10-item Abbreviated Parent-Teacher Questionnaire (APTQ), normative data for parental ratings on the APTQ are rare. Moreover, its psychometric properties as a stand alone behavioral rating instrument have yet to be examined in detail. Using data from parental ratings for 6,841 children aged 5 to 14 years, this paper reports the psychometric properties of the APTQ and provides normative and prevalence estimates for four age cohorts (5 to 6, 7 to 8, 9 to 11, and 12 to 14 years) by gender. In presenting the findings, the paper highlights key methodological issues endemic to the design of behavioral rating inventories like the APTQ and the analysis of data derived from them. These issues are illustrated and discussed in terms of their implications for the measurement and determination of prevalence estimates of problem behaviors in child psychology and child psychiatry. The need to revise the design, content, and response formats of child behavior rating inventories is stressed.     

Turning the table on advice programs for parents: Using placemats to enhance family interaction at restaurants

There are many opportunities in a family's daily routine to enrich the interactions among its members. One such opportunity arises at family restaurants. Surveys of restaurant personnel and customers suggested the possibility of enriching family interactions by redesigning indigenous materials such as table placemats. Accordingly, we developed Table-Talk placemats that provided conversational topics and illustrated games in which the entire family could participate. After some testing of these placemats in a preschool, a field experiment was conducted with families dining in restaurants. Table-Talk placements occasioned more social and educational dialogue among family members than either traditional-placemat or no-material conditions. Social validation ratings provided by mental health counselors and the parents suggested that Table-Talk placemats occasioned healthy and enjoyable interactions among family members.     

MODIFICATION OF SEIZURE DISORDERS: THE INTERRUPTION OF BEHAVIORAL CHAINS1

This study investigated the effects of interruption and differential reinforcement on seizures in children. Seizures were conceptualized as the terminal link in a behavioral chain, resulting in a strategy aimed at identifying and modifying behaviors that reliably preceded the seizure climax. Seizure frequency was reduced in four of five subjects, whereas the frequency of preseizure behavior was reduced in only three subjects. Parents and school personnel were successfully used as change agents.     

Parent-perceived child behavior problems: Comparison of normative and clinical factors of the Adelaide-Conners Parent Rating Scale

The Adelaide-Conners Parent Rating Scale (APRS), an instrument developed by studying a large, representative group of schoolchildren, was used with a group of psychiatry attenders. Multimethod factor analysis found satisfactory agreement between the factor structures of the clinical and the normative groups. The patterns of scores on the 12 APRS scales were also compared. Two higher-order factors (Conflict with the Environment and Conflict within the Self) were identified in the clinical sample as previously found in the normative group. Comparison of the factor solutions with previous empirical efforts to identify parent-perceived patterns of child behavior disorder showed that the APRS compares well with other instruments and supports the strategy of proceeding from the study of normative populations to the study of clinically defined groups.This work was supported in part by a grant from the Department of Health, Canberra.