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.

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.

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.

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.

As more evidence-based programs are implemented in community settings, there is a strong need to ensure those models are implemented with integrity. Implementation of programs should be evaluated for fidelity, the degree of adherence to treatment protocols, and competence, the level of skill in implementation (Schoenwald et al., 2011). The purpose of this study was to review audio recordings of SafeCare home visiting sessions to discover the relationship between the measures of fidelity and competence. Six coders were assigned 209 SafeCare home visiting audiotapes to be coded for fidelity and competence. A sample of audios were double coded to evaluate fidelity and competence scores for inter-rater reliability. Fidelity and competence items were classified into process and content categories, forming the six main variables of process fidelity, content fidelity, total fidelity, process competence, content competence, and total competence. Total fidelity correlated with total competence at a level of .615, with process fidelity and process competence correlating at a much lower level than content items. The total correlation level can be interpreted as that fidelity and competence are strongly related measures, but are not identical constructs. The goal for SafeCare coders would be to continue refining competence definitions and attempting to remove the subjective nature from the competence coding process. With these two efforts, competence reliability should increase to an acceptable level. Given the main fidelity and competence correlation level, it is advisable for SafeCare coders to continue to code both fidelity and competence to avoid missing valuable components of the session. Additional research may be needed once the competence scale becomes better established.

Family level data was collected from those served in a state-wide rollout of SafeCare® in Georgia between January of 2010 and November of 2011. Families who received SafeCare were trained in the intervention’s three modules: Parent-Child or Parent-Infant Interaction, Home Safety, and Child Health. The purpose of this study was to measure changes in parental skill demonstration by analyzing pre- and post-training assessments. Additionally, parental demographic characteristics were also assessed for associations with skill acquisition within each module. Follow-up analysis concluded that families displayed increases in parenting skills among all SafeCare modules. Moderator analysis showed that those with only one child showed greater decreases in home hazards as did those with two children. Also, it was found that income level moderated performance in the Parent-Child Interaction module with participants below the median income level exhibiting a greater increase in PCI skill demonstration than those above the median income level. Further research should consider modeling multiple parental characters (e.g. CPS status and income) with skill performance over time. Lastly, additional research should aim to determine if those who exhibit increases in parenting skills are also less likely to experience future child maltreatment reports.

Parents of children with autism spectrum disorder (ASD) face many challenges which lead to low levels of psychological well-being, partly caused by inability to parent in accordance with one’s values. Child-directed play, a moment of being fully attentive and responsive to one’s child, has the potential to increase parental values. A non-concurrent multiple-baseline experimental design investigated whether daily exercises of child-directed play improved valued parenting and parental perspective-taking. Eight parents of children with diagnosed or suspected ASD were followed daily for six weeks. The intervention comprehended daily practice of child-directed play and video supervision. Child-directed play increased ratings of parental values for all but one participant (Hedges’ g* = 1.67) with effect maintained at follow-up, and increased ratings of parental perspective-taking. A gradual effect indicates the need for greater difference in baseline length between participants. No effects on children, nor on parental well-being were investigated in the present study.