Despite a well-documented need for parent training in the treatment and prevention of child behavior problems, as well as the well-documented benefit of including fathers in preventative and treatment interventions, surprisingly little clinical intervention research examines the role of fathers in such trainings. This research examined the role of father involvement in behavioral parent training by examining parent-related characteristics in relation to treatment outcomes for both mothers and fathers, examining differences between mothers and fathers, and examining the additive benefit of including fathers in treatment across two studies. Both studies utilized archival data obtained from a university- and community-based parent training program for families and service providers of children displaying challenging or disruptive behavior offered through a large south eastern university medical center. The first study examined associations and relationships among parenting knowledge, parenting stress, and treatment engagement in 39 fathers and 107 mothers. The second study examined the associations and relationships among child behavior problems, treatment engagement, and therapy attitudes in 43 fathers and 98 mothers. Surprising patterns of effects were found; overall, the pattern of results of both studies across multiple levels indicated that the treatment was effective and that the pre-post changes observed were robust to a number of covariates. These findings indicate that the observed treatment efficacy was not diminished when examining specific groups of participants. It is possible that specific strengths of the program discussed in detail such as the social support and problem-solving opportunities augmented treatment benefit for subgroups of participants and mitigated the impact of group differences. While differences between mothers and fathers are often portrayed as having dramatic impacts on treatment engagement and efficacy, these group differences may not be as straightforward as is commonly depicted in the literature. Treatments that identify the nature of differential patterns of benefit and address them through treatment design may be able to deliver efficacious treatment generalizable to multiple subgroups of parents. These findings may have important implications for improving treatment engagement and treatment efficacy in the future. Based on the synthesized findings of these two studies, recommendations for treatment development, clinical practice, and future research are discussed.

The goal of this Whanau Whakapakari (Strengthening Families) research was to define critical aspects of Māori experiences and views on child-rearing practices, and to describe whanau (extended family) values and expectations for tamariki (children) and mokopuna (grandchildren). Furthermore, these Māori views were included in culturally adapted parent-training programmes. The overall aim was to devise an approach to emphasise client strengths and provide best outcomes for research participants. Qualitative aspects included discussing the research processes in the Māori community by acknowledging the roles of whanau, hapu (sub-tribal), and iwi (tribal) structures. I also identified the importance of pan-tribal and urban Māori groups in the current research. As the project developed, an ongoing consultation and feedback protocol was established to ensure that Māori views on the research and the written outcomes were recognised. In-depth interviews with kaumatua (elders), and focus groups with Māori service providers and Māori parents were analysed qualitatively to establish Māori values in child rearing and parenting, and the knowledge and skills that contribute to effective parenting and family functioning. Values identified from these participants confirmed the central role of whanaungatanga (family connections), whakapapa (genealogy), and awhinatanga (support) for Māori. Two culturally adapted parent-training programmes, the Matuatanga (Parenting) Relationships Model and the Matuatanga Values Model programmes, were developed and compared with a Standard Parent Training programme. The Matuatanga Relationships Model programme emphasised the importance of child, parent and whanau relationships and interactions. The Matuatanga Values Model programme emphasised Māori values derived from the qualitative data - whanaungatanga, whakapapa and awhinatanga. A range of pre- and post-training measures were undertaken to identify acceptable and appropriate measures for quantifying parent-training outcomes. These included questions on support networks, parent expectations of children, parental self-efficacy, parental self-rating, critical-incident scenarios, and programme evaluation. While 78 participants attended at least one of the research sessions 22 participants provided pre- and post-training measures for the Whanau Whakapakari programmes. Results showed that there was a medium effect size improvement across all Standard Parent Training and Matuatanga Model programmes and a statistically significant improvement in the Standard Parent Training and Matuatanga Relationship Model programmes. There were no statistically significant differences between the outcomes of the different programmes but qualitative differences from evaluation and feedback data were considered in identifying specific skills acquisition, general understanding and enjoyment components in the programmes. Results from the different measures indicated that parent expectations and critical-incident scenario measures provided the most information on post-training changes. Analysis of the outcome data with the attendance patterns confirmed the value of parent-training programmes per se and indicated that at least in the short term, parent effectiveness scores continued to improve for participants who continued to attend for more than one programme. Programme follow-ups considered natural whanau supports in the Māori community and issues of social and cultural validity. Integration of standard parent-training concepts and cultural concepts suggest a multi-dimensional approach which recognises parenting skills acquisition and cultural validation of whanau concepts relevant to parenting for Māori.

Little research has been conducted focusing on parent training strategies aimed at teaching parents with an intellectual disability to implement strategies to decrease their child's problem behaviour and increase appropriate behaviours. This study aimed to do two things. First, to examine the effectiveness of an enhanced assessment-based BPT intervention that was implemented by parents with an intellectual disability with children with problem behaviour. Second, the current study also aimed to test the effectiveness of the parent training package used to teach parents to implement the intervention strategies. Importantly, in an attempt to identify the training condition, or combination of conditions, most needed to achieve behaviour change, individual conditions of a multi-condition parent training package were additively introduced during parent training based on the degree of intrusiveness in the target routine combined with the amount of structure required by the teaching strategy. Five parents were taught to implement a functional assessment driven intervention plan aimed at increasing their child's appropriate behaviour and decreasing their problem behaviour during a valued family routine. In order to establish the combination of parent training strategies that were sufficient to teach parents to effectively implement the intervention plan, a series of parent training strategies were introduced in a planned way. The strategies included role-play, verbal instruction, verbal instruction plus feedback, coaching and video-feedback. Results showed that for all parents skill acquisition did not occur until the final phase, video-feedback. Successful implementation of the intervention resulted in a corresponding increase in child appropriate behaviour and decrease in child problem behaviour. In addition to that, parents rated the social validity and contextual fit of the intervention highly.

Adolescence is a period of enormous adjustment for both teenagers and families. As children transition from childhood to adulthood, they go through many physical, emotional and behavioural changes. Not surprisingly, many parents describe adolescence as the most difficult and anxiety-provoking period of their children’s life. Parents’ concerns are well justified, considering the high prevalence of emotional and behavioural problems during adolescence. Although health professionals and researchers share parents’ view of adolescence as a challenging period of life, the scope of research on adolescents is scarce compared to research on children and adults. However, this is now changing. Research on adolescent development and adolescent psychopathology has increased dramatically during the last two decades. Reducing risk factors in adolescents’ development has been receiving more and more attention both from researchers and policy makers. Family risk factors such as inadequate parental monitoring and family conflict are among potentially modifiable risk factors that can be targeted in order to reduce the rate of emotional and behavioural problems in adolescents. Behavioural family intervention is considered to be one of the promising intervention systems in this area because of the extensive empirical support it has received in research with families of preadolescence children. The research presented in this thesis focuses on parenting programs for parents of teenagers. The first study evaluates the efficacy of a behavioural family intervention (Triple P – Positive Parenting Program) targeting parents of teenagers. The second study explores factors which affect parents’ decisions to participate in parenting programs. The first study outlines a randomised control trial (RCT), assessing the efficacy of a parenting intervention in reducing behavioural problems in adolescents. The study provides support for an intensive individual version of Teen Triple P – a behavioural family intervention designed specifically for parents of high risk adolescents. The intervention aims to improve adolescent behaviour by reducing parents’ use of ineffective parenting. Participants were 46 families with a teenager aged 11 to 16. The outcomes of the intervention included a reduction in teen disruptive behaviours (d > .85) and parent-adolescent conflict (d = .1.21), as well as decreased parental use of harsh and coercive parenting strategies (d = 1.15) and a decrease in parents’ conflict over child rearing issues (d = .64). These positive changes were maintained at the three-month follow up. In spite of the growing recognition of parents’ need for information, guidance and support during the crucial and challenging years of adolescence, little is known about the factors which affect parents’ engagement in programs designed to help them in their parenting roles. The second study aimed to provide a conceptual framework for understanding parents’ decisions to accept or decline participation in a parenting program by employing the Health Belief Model (HBM). The model suggested that parents are more likely to participate in a program when they (a) perceive their adolescents to be susceptible to development of problem behaviours, (b) perceive the problem behaviours to have serious consequences, (c) believe the parenting program to be beneficial in reducing the risk of development of problem behaviours in their adolescent, (d) perceive the personal, social and financial cost of attending the program to be low, and (e) are confident in their ability to successfully learn and apply what they learn in these programs. The model explained 31% of the variance in parents’ inclination to participate in parenting programs. The study also showed that parents differ in their preferences of delivery format for parenting programs. These two studies contribute to the literature in a number of ways. Firstly, they demonstrate that parent training is an effective intervention in the treatment of adolescent problem behaviours. Secondly, they highlight the importance of addressing parents’ beliefs and attitudes about the benefits of parenting programs as well as reducing participation barriers to encourage greater parental engagement in prevention and intervention programs. Finally, the research emphasises that in order to increase participation rate, parenting programs should be made available in a range of delivery formats. The implications of the current research and future directions are presented and discussed.

<p>Syftet med denna uppsats var att studera föräldrarnas upplevelser och erfarenheter av att delta i en föräldrautbildning. Studiens frågeställning var: Hur beskriver ett mindre urval föräldrar sina upplevelser och erfarenheter av att delta i parent training? För att besvara frågeställningen tillämpades en kvalitativ metod där djupintervjuer genomfördes med två föräldrapar och två ensamstående mödrar. Samtliga hade genomgått föräldrautbildningen parent training i regi av barn- och ungdomspsykiatrin under år 2004. Gemensamt för samtliga föräldrar var att de kände sig lugnare och mer trygga i föräldrarollen efter avslutad utbildning. Föräldrarna upplevde också mötet med andra föräldrar som mycket positivt och som en bekräftelse i att de inte är ensamma om att vara föräldrar till ett barn med beteendeproblem. Studiens resultat analyserades i ett mångdimensionellt perspektiv och utifrån en hermeneutisk forskningsansats. Analysverktygen var kognitiv teori, social konstruktionism och socialpsykologisk rollteori. Teorierna visade sig särskilt fruktbara i analysen av föräldrarnas upplevelser då föräldrarna erhöll nya kognitioner om föräldrarollen, och i förhållande till sitt barn. Resultatet ligger i linje med tidigare forskning.</p>

Syftet med denna uppsats var att studera föräldrarnas upplevelser och erfarenheter av att delta i en föräldrautbildning. Studiens frågeställning var: Hur beskriver ett mindre urval föräldrar sina upplevelser och erfarenheter av att delta i parent training? För att besvara frågeställningen tillämpades en kvalitativ metod där djupintervjuer genomfördes med två föräldrapar och två ensamstående mödrar. Samtliga hade genomgått föräldrautbildningen parent training i regi av barn- och ungdomspsykiatrin under år 2004. Gemensamt för samtliga föräldrar var att de kände sig lugnare och mer trygga i föräldrarollen efter avslutad utbildning. Föräldrarna upplevde också mötet med andra föräldrar som mycket positivt och som en bekräftelse i att de inte är ensamma om att vara föräldrar till ett barn med beteendeproblem. Studiens resultat analyserades i ett mångdimensionellt perspektiv och utifrån en hermeneutisk forskningsansats. Analysverktygen var kognitiv teori, social konstruktionism och socialpsykologisk rollteori. Teorierna visade sig särskilt fruktbara i analysen av föräldrarnas upplevelser då föräldrarna erhöll nya kognitioner om föräldrarollen, och i förhållande till sitt barn. Resultatet ligger i linje med tidigare forskning.

Child maltreatment (CM) is a major public health problem in the United States which affects millions of children each year. Because parents are responsible for the majority of substantiated CM reports, behavioral parent training is recommended as the primary prevention strategy. In recent years, researchers and clinicians have begun work examining the relevance and effectiveness of making cultural adaptations to parent training programs. The purpose of this study was to explore the need for systemic cultural adaptations to SafeCare®, an evidence-based parent-training child maltreatment prevention program. SafeCare is currently implemented in nine states and SafeCare providers are serving families representing a wide array of cultures and ethnicities. Eleven SafeCare providers, representing six states, participated in individual, semi-structured interviews to determine what, if any, cultural adaptations were in place in the field and whether there was a need for systematic culture-specific or general cultural adaptations to the SafeCare model. The interviews provided evidence that, across sites and populations, adaptations are being made when implementing SafeCare with diverse families. Providers expressed a need to make the language/reading levels of the model materials more relevant for all the populations served. Overall, however, providers found the model to be flexible and amenable to working with families of various cultures and ethnicities. Providers recommended against systematic adaptations of the model for specific ethnic groups.

As evidence-based programs are implemented in real world settings, there is a strong need to effectively and efficiently monitor fidelity, or adherence to a program, in order to maintain the expected effects demonstrated in research settings. The purpose of this study was to compare two methods of assessing fidelity to an evidence-based, parent-training model (SafeCare®) as implemented by community service providers. Specifically, analyses compared fidelity assessed via video versus audio recordings. SafeCare modules often require mobility and high interaction, thus, video recordings may provide a more accurate view of home visitor and family interactions for scoring fidelity. However, videos are more expensive and cumbersome in comparison to audio recordings. Trained coders were randomly assigned to score a video or audio recording of the same session for 25 SafeCare sessions and the codes were compared for agreement. Two types of SafeCare sessions were assessed: assessment and training. Average agreement was somewhat higher for assessment sessions than for training sessions. Average agreement, across all sessions, was higher among items pertaining to SafeCare content than items pertaining to the therapeutic process. Several specific items were identified that are difficult to code via audio recordings. However, more research is needed to determine agreement levels across all SafeCare modules and session types in order to provide insight on the implications for SafeCare's future use of audio and video methods of measuring fidelity.

Youth offending is an issue that receives attention at many levels, and which crosses the already broad domains of justice, education, mental health and social services. The role of parents in the development of antisocial behaviour, and their responsibilities with regard to addressing the consequences of this, are controversial. This article reviews a selection of interventions for managing teenage behaviour, and specifically criminal offending. A trend emerges from this review whereby the most effective treatments for young offenders are those that achieve change within the family system, not just the young person. The current study examined the effect of implementing Group Teen Triple P, one of a suite of well established and effective behavioural parent training programmes, with the parents of teenagers who had been recently involved in offending. The group was a collaborative partnership between Presbyterian Support, a non-government organization, and Child, Youth and Family Services, the national, statutory provider of care and protection and youth justice services. The six participating families had previously been involved with one or both of these agencies. Participants completed questionnaires and interviews at three data collection points, and the researcher also took part in aspects of the intervention. The results indicate positive changes within some of the participating families, but are inconsistent due to the drop-out rate and the reluctance of participating parents to consistently implement the skills and strategies learned. This unexpected but nevertheless important finding necessitated further consideration of the reasons why it occurred, and these are discussed in the context of earlier research into variables which influence attendance and adherence to parent training interventions. This study offers insights into the provision of behavioural parent training programmes with vulnerable, fragile or high-risk families.

Adolescence is a period of enormous adjustment for both teenagers and families. As children transition from childhood to adulthood, they go through many physical, emotional and behavioural changes. Not surprisingly, many parents describe adolescence as the most difficult and anxiety-provoking period of their children’s life. Parents’ concerns are well justified, considering the high prevalence of emotional and behavioural problems during adolescence. Although health professionals and researchers share parents’ view of adolescence as a challenging period of life, the scope of research on adolescents is scarce compared to research on children and adults. However, this is now changing. Research on adolescent development and adolescent psychopathology has increased dramatically during the last two decades. Reducing risk factors in adolescents’ development has been receiving more and more attention both from researchers and policy makers. Family risk factors such as inadequate parental monitoring and family conflict are among potentially modifiable risk factors that can be targeted in order to reduce the rate of emotional and behavioural problems in adolescents. Behavioural family intervention is considered to be one of the promising intervention systems in this area because of the extensive empirical support it has received in research with families of preadolescence children. The research presented in this thesis focuses on parenting programs for parents of teenagers. The first study evaluates the efficacy of a behavioural family intervention (Triple P – Positive Parenting Program) targeting parents of teenagers. The second study explores factors which affect parents’ decisions to participate in parenting programs. The first study outlines a randomised control trial (RCT), assessing the efficacy of a parenting intervention in reducing behavioural problems in adolescents. The study provides support for an intensive individual version of Teen Triple P – a behavioural family intervention designed specifically for parents of high risk adolescents. The intervention aims to improve adolescent behaviour by reducing parents’ use of ineffective parenting. Participants were 46 families with a teenager aged 11 to 16. The outcomes of the intervention included a reduction in teen disruptive behaviours (d > .85) and parent-adolescent conflict (d = .1.21), as well as decreased parental use of harsh and coercive parenting strategies (d = 1.15) and a decrease in parents’ conflict over child rearing issues (d = .64). These positive changes were maintained at the three-month follow up. In spite of the growing recognition of parents’ need for information, guidance and support during the crucial and challenging years of adolescence, little is known about the factors which affect parents’ engagement in programs designed to help them in their parenting roles. The second study aimed to provide a conceptual framework for understanding parents’ decisions to accept or decline participation in a parenting program by employing the Health Belief Model (HBM). The model suggested that parents are more likely to participate in a program when they (a) perceive their adolescents to be susceptible to development of problem behaviours, (b) perceive the problem behaviours to have serious consequences, (c) believe the parenting program to be beneficial in reducing the risk of development of problem behaviours in their adolescent, (d) perceive the personal, social and financial cost of attending the program to be low, and (e) are confident in their ability to successfully learn and apply what they learn in these programs. The model explained 31% of the variance in parents’ inclination to participate in parenting programs. The study also showed that parents differ in their preferences of delivery format for parenting programs. These two studies contribute to the literature in a number of ways. Firstly, they demonstrate that parent training is an effective intervention in the treatment of adolescent problem behaviours. Secondly, they highlight the importance of addressing parents’ beliefs and attitudes about the benefits of parenting programs as well as reducing participation barriers to encourage greater parental engagement in prevention and intervention programs. Finally, the research emphasises that in order to increase participation rate, parenting programs should be made available in a range of delivery formats. The implications of the current research and future directions are presented and discussed.