FEASIBILITY,ACCEPTABILITY, AND INITIAL FINDINGS FROM A COMMUNITY‐BASED CULTURAL MENTAL HEALTH INTERVENTION FOR AMERICAN INDIAN YOUTH AND THEIR FAMILIES

Through a CBPR partnership, university and American Indian (AI) tribal members developed and tested Our Life intervention to promote mental health of AI youth and their families by addressing root causes of violence, trauma, and substance abuse. Based on premises that well‐being is built on a foundation of traditional cultural beliefs and practices, and that it requires a process of healing and understanding, the 6‐month intervention had four components: 1) recognizing/healing historical trauma; 2) reconnecting to traditional culture; 3) parenting/social skill‐building; and 4) strengthening family relationships through equine‐assisted activities. Feasibility, acceptability, appropriateness, and preliminary outcomes were examined in a mixed‐method within‐group design. Engagement and retention were challenging, suggesting that families faced numerous barriers to participation. Youth who completed the program experienced significant increases in cultural identity, self‐esteem, positive coping strategies, quality of life, and social adjustment. Qualitative data supported these findings and suggested additional positive effects.     

Empirical Support for a Treatment Program for Families of Young Children With Externalizing Problems

We evaluated the efficacy of a manualized multimodal treatment program for young externalizing children. Families were assigned randomly to an immediate 12-week parent and child treatment condition (n = 24) or to a delayed-treatment condition (n = 23). Parents had high attendance, high satisfaction with treatment, and increased knowledge of behavior management principles. Relative to the waitlist condition, treatment parents reported statistically and clinically significant reductions in child behavior problems, improved parenting practices (i.e., increased consistency, decreased power assertive techniques), an increased sense of efficacy, and reduced parenting stress. There was a trend toward parents improving their attitudes toward their children. In considering the process of change, we found evidence that improved parenting practices mediated reductions in child behavior problems and that child improvements mediated changes in parent attitudes and stress. Five months following treatment, teachers reported significant improvements in child behaviors, whereas parents reported that reductions in child behavior problems and parenting stress were maintained.     

Mothering from the Inside Out: results of a pilot study testing a mentalization-based therapy for mothers enrolled in mental health services

Mothers who are involved with mental health services (for themselves or their children) rarely receive adequate support for their role as parents. Mental illness in a parent or child often exacerbates the challenges of managing psychological distress that is germane to the parenting roll. Mentalization-based approaches to psychotherapy for parents have the potential to address challenges of emotional regulation in parents by supporting their capacity to recognize and modulate negative affect during stressful parenting situations. In this study, we piloted Mothering from the Inside Out (MIO) with 17 mothers receiving services at a community-based mental health clinic. MIO is a 12-week, mentalization-based parenting intervention that demonstrated efficacy in two previous randomized controlled trials with substance using mothers. In this study, we were interested in determining whether community-based clinicians could deliver MIO with sustained fidelity. We were also interested in examining the preliminary feasibility, acceptability and efficacy of MIO when delivered by clinicians in a community mental health center. Finally, we were interested in replicating prior tests of the proposed treatment mechanisms. Treatment outcomes included maternal reflective functioning, psychiatric and parenting stress, and mother–child interaction quality. Our findings indicated that MIO was feasible and acceptable when delivered in the community-based setting and that all maternal indices improved. However, no improvement in mother–child interaction quality was found, possibly because of insufficient time for these changes to consolidate.     

Social capital,safety concerns,parenting, and early adolescents' antisocial behavior

This study explores the relations between neighborhood social capital (neighbor support and social climate), safety concerns (fear of crime and concern for one's child), parenting (solicitation and support), and adolescent antisocial behavior in a sample of 952 parents (742 mothers) and 588 boys and 559 girls from five middle schools (sixth through eighth grades) in a midsize Italian city. In structural equation models, social capital is strongly and inversely related to safety concerns and positively related to parental support and solicitation. In turn, safety concerns are also positively related to parental support and solicitation. Social capital and safety concerns have indirect effects on children's antisocial behavior through their effects on parenting. Implications are discussed for parenting and community‐based interventions to prevent or reduce youth antisocial behaviors. © 2010 Wiley Periodicals, Inc.     

Tuning in to kids: an emotion‐focused parenting program—initial findings from a community trial

This study evaluated a new group parenting program, Tuning in to Kids, which taught emotion coaching skills to parents of preschool children. In a randomized control trial, 218 primary caregiver parents of children aged 4.0–5.11 years completed questionnaires assessing parent emotion socialization (emotion coaching vs. emotion dismissing), parent emotional competence, parent wellbeing and child behavior. Assessment occurred at preintervention and 10 weeks later. Parents randomized to the intervention condition (n=107) attended a 6‐session parenting program. Results showed parents in the intervention condition reported significant increases in emotion coaching and significant reductions in emotion dismissing with their children. Child behavior was also reported to improve. Of those with clinical levels of behavior difficulties, more than half were no longer at clinical level postprogram. These findings suggest that an emotion‐focused parenting intervention may assist parents to learn emotion‐coaching skills that have been linked to improved child behavior. © 2009 Wiley Periodicals, Inc.     

Impact of music therapy to promote positive parenting and child development

The effectiveness of a 10-week group music therapy program for marginalized parents and their children aged 0-5 years was examined. Musical activities were used to promote positive parent-child relationships and children's behavioral, communicative and social development. Participants were 358 parents and children from families facing social disadvantage, young parents or parents of a child with a disability. Significant improvements were found for therapist-observed parent and child behaviors, and parent-reported irritable parenting, educational activities in the home, parent mental health and child communication and social play skills. This study provides evidence of the potential effectiveness of music therapy for early intervention.     

Parent and Child ADHD Symptoms in Relation to Parental Attitudes and Parenting: Testing the Similarity-Fit Hypothesis

Objective: We tested the similarity-fit hypothesis that predicts more positive parenting when both parent and child have high levels of ADHD symptoms compared to when only one does. Method: Mothers and fathers of 156, 5 to 13 year old sons participated (110 boys with ADHD, 46 without). Parent inattentive and hyperactive-impulsive symptoms were examined, in interaction with child ADHD, as predictors of parental tolerance, empathy, encouragement of child autonomy, and positive parenting. Results: Several interactions of parent ADHD symptoms and child ADHD were detected which suggested that for parents with low levels of symptoms, the presence of child ADHD was associated with less positive parenting attitudes and behavior, but this negative relation between positive parenting and child ADHD was dampened among parents with more ADHD symptoms. Conclusions: Considered alongside the well documented parenting difficulties associated with parental ADHD, our findings suggest that parental ADHD symptoms also may help to mitigate some of the challenges facing families of children with ADHD.     

The efficacy of VIPP-V parenting training for parents of young children with a visual or visual-and-intellectual disability: a randomized controlled trial

Video-feedback Intervention to promote positive parenting-visual (VIPP-V) or visual-and-intellectual disability is an attachment-based intervention aimed at enhancing sensitive parenting and promoting positive parent–child relationships. A randomized controlled trial was conducted to assess the efficacy of VIPP-V for parents of children aged 1–5 with visual or visual-and-intellectual disabilities. A total of 37 dyads received only care-as-usual (CAU) and 40 received VIPP-V besides CAU. The parents receiving VIPP-V did not show increased parental sensitivity or parent–child interaction quality, however, their parenting self-efficacy increased. Moreover, the increase in parental self-efficacy predicted the increase in parent–child interaction. In conclusion, VIPP-V does not appear to directly improve the quality of contact between parent and child, but does contribute to the self-efficacy of parents to support and to comfort their child. Moreover, as parents experience their parenting as more positive, this may eventually lead to higher sensitive responsiveness and more positive parent–child interactions.     

Parent–child attachment: meta-analysis of associations with parenting behaviors in middle childhood and adolescence

Maternal sensitivity predicts mother–child attachment in young children, but no meta-analysis has investigated the link between parenting and parent–child attachment in older children. This study examined the relationship between parent–child attachment and multiple components of parenting in children 5–18 years of age. A series of meta-analyses showed that parents of children with more secure attachment are more responsive, more supportive of the child’s autonomy, use more behavioral control strategies, and use less harsh control strategies. Parents of children with more avoidant attachment were less responsive and used less behavioral control strategies. Ambivalent attachment was not significantly related to any of the parenting behaviors, and there were not enough studies to reliably test the relationship between disorganized attachment and parenting. There were few significant moderators. The findings inform new areas for future research, as well as family interventions for at-risk youth.     

IMPACT OF THE DARE TO BE YOU FAMILY SUPPORT PROGRAM: COLLABORATIVE REPLICATION IN RURAL COUNTIES

Rural families often have unmet needs for services to strengthen family functioning and promote optimal youth development. Community needs assessments conducted at 2 rural sites led to a community‐university collaboration that implemented the DARE to be You (DTBY) program for families and youth aged 9 years at one site and aged 13 years at the second site. Families in the DTBY intervention, in contrast to a matched comparison group, evinced significantly greater gains in parent self‐efficacy, effective child‐rearing practices (i.e., more democratic and less coercive), and positive parent‐child relationships. As well, changes to community assets were documented in the form of increased human services to strengthen families. The results are discussed in terms of the utility of community–university partnerships to help strengthen rural families and promote community social capital.     

Positive Parenting and Callous-Unemotional Traits: Their Association With School Behavior Problems in Young Children

The current study tested the associations of both positive (i.e., warm and responsive) and negative (i.e., harsh and inconsistent) aspects of parenting with callous-unemotional (CU) traits and conduct problems. Caregivers and teachers of 92 ethnically diverse (33% African American) kindergarten students (61% female) were recruited to complete a series of survey measures. Students’ average age was 6.2 (SD = 0.42) years. Parent report of positive parenting practices, but not negative parenting practices, was associated with teacher report of conduct problems. Further, positive parenting interacted with CU traits in their association with conduct problems. Parental use of positive reinforcement was more strongly negatively related to conduct problems for youth with high levels of CU traits, whereas parent–child cooperation was positively related to conduct problems only for youth with low levels of CU traits. Finally, only parental warmth was negatively correlated with CU traits after controlling for level of conduct problems. Results were generally not moderated by the child’s gender or ethnicity. These findings highlight the importance of positive parenting practices for understanding CU traits and as potential targets in clinical interventions to treat children who show elevated levels of these traits.     

DO PARENTS THINK IT TAKES A VILLAGE? PARENTS’ ATTITUDES TOWARDS NONPARENTAL ADULTS’ INVOLVEMENT IN THE UPBRINGING AND NURTURE OF CHILDREN

The current study explored parents’ attitudes towards nonparental adults’ involvement in childrearing practices. Parents’ attitudes were operationalized in their willingness to share parenting responsibility and interest to participate in parenting activities. Data were collected through a quantitative survey with 1,090 parents from 17 Dutch neighborhoods. Results suggest that parents are ambivalent about involving others in childrearing practices. Furthermore, parents seem to prefer activities that do not focus explicitly on childrearing, but that do assist them in handling parenting tasks or give them the opportunity to exchange experiences. Fathers, parents with more sources of informal support, and parents who gave support themselves were more willing to share responsibility, whereas non‐Western parents, parents with positive judgments on cohesion and trust in their neighborhood, parents with more sources of formal support, and parents who gave support themselves were more interested in participating in activities.     

Parenting in the community: A service evaluation of a universal,voluntary sector parenting intervention

Evidence based parenting programs have been shown to improve parenting competence and reduce child behavior problems. More rigorous evaluations of such programs are needed in community contexts. This study provides such an evaluation of The Parenting Children Course, a voluntary sector program that is being run both Live and on DVD within a church context. A total of 225 parents participated in the study. Standardized questionnaires were used to measure key parenting variables before and after the course, and at follow‐up 3 months later. Taking the course improved parents’ confidence and reduced parental negativity, but did not improve positive parenting skills. Parents reported that child behavior and family functioning also improved by the end of the course. There were no signs of decay at 3‐month follow‐up. Strengths and limitations of the study, implications for clinical practice and directions for future research, are discussed.     

Should parents be co-clients in cognitive-behavioral therapy for anxious youth?

Cognitive-behavioral therapy (CBT) for anxiety disorders in youth has been evaluated in randomized clinical trials (RCTs), and recent studies have sought to determine if the effects can be enhanced by an adjunctive parent component. The rationale for adding parents as active participants to treatment for anxious youth includes the notions that parenting factors (a) can contribute to the maintenance of anxiety, (b) could facilitate the generalization of treatment gains, and (c) have had favorable results in treatment of other childhood disorders. To date, there have been 9 CBT treatment outcome trials with anxious youth that included parents in treatment. This article (a) provides a critical review of the research on active parent involvement in CBT of anxious youth, (b) calculates and reports effect sizes emerging from these studies, and (c) recommends areas for future research.     

Should Parents Be Co-Clients in Cognitive-Behavioral Therapy for Anxious Youth?

Cognitive-behavioral therapy (CBT) for anxiety disorders in youth has been evaluated in randomized clinical trials (RCTs), and recent studies have sought to determine if the effects can be enhanced by an adjunctive parent component. The rationale for adding parents as active participants to treatment for anxious youth includes the notions that parenting factors (a) can contribute to the maintenance of anxiety, (b) could facilitate the generalization of treatment gains, and (c) have had favorable results in treatment of other childhood disorders. To date, there have been 9 CBT treatment outcome trials with anxious youth that included parents in treatment. This article (a) provides a critical review of the research on active parent involvement in CBT of anxious youth, (b) calculates and reports effect sizes emerging from these studies, and (c) recommends areas for future research.     

Disease management, coping, and functional disability in pediatric sickle cell disease

BackgroundYouth with sickle cell disease (SCD) experience chronic symptoms that significantly interfere with physical, academic, and social-emotional functioning. Thus, to effectively manage SCD, youth and caregivers must work collaboratively to ensure optimal functioning. The goal of the current study was to examine the level of involvement in disease management tasks for youth with SCD and their caregivers. The study also examined the relationship between involvement in disease management tasks, daily functioning, and coping skills. The study utilized collaborative care and disease management theoretical frameworks.MethodsYouth and caregivers participated in the study during an annual research and education day event. Forty-seven patients with SCD aged 6 to 18 years and their caregivers completed questionnaires examining level of involvement in disease management tasks, youth functional disability, and youth coping strategies. Caregivers also completed a demographic and medical history form.ResultsParents and youth agreed that parents were significantly more involved in disease management tasks than youth, although level of involvement varied by task. Decreased parent involvement was related to greater coping strategies used by patients, including massage, prayer, and positive thinking. Higher functional disability (lower functioning) was related to greater parent involvement in disease management tasks, suggesting that greater impairment may encourage increased parent involvement.ConclusionsHealth professionals working with families of youth with SCD should discuss with parents and youth how disease management tasks and roles will be shared and transferred during adolescence. Parents and youth may also benefit from a discussion of these issues within their own families.     

A promising parenting intervention in foster care

The purpose of this study was to evaluate the effectiveness of a 2-component intervention for biological and foster parent (pairs) to improve parenting practices, co-parenting, and child externalizing problems. Participants were biological and foster parents (N=128) of primarily neglected children (ages 3 to 10 years) placed in regular foster homes. Biological and foster parents were randomly assigned in pairs to the intervention (n=80) or a usual care (n=48) condition. Intervention families received a 12-week parenting course (Incredible Years) and a newly developed co-parenting component. Key findings included significant gains in positive parenting and collaborative co-parenting for both biological and foster parents at the end of the intervention. At follow-up, intervention parents sustained greater improvement in positive parenting, showed gains in clear expectations, and reported a trend for fewer child externalizing problems. Findings supported the feasibility of offering joint parenting training to meet the needs of participating families and demonstrated that the co-parenting construct applied to families in the foster care system was amenable to intervention.     

Video feedback in widescreen: a meta-analysis of family programs

A meta-analysis of 29 studies (n=1844 families) shows statistically significant positive effects of video feedback interventions on the parenting behavior and attitude of parents and the development of the child. Parents become more skilled in interacting with their young child and experience fewer problems and gain more pleasure from their role as parent. Shorter programs appeared to be more effective in improving parenting skills. The intervention effects were smaller for the attitude domain at parent level. The experimental outcomes were smaller at child level if the parents belonged to a high-risk group.     

Effects of culturally adapted parent management training on Latino youth behavioral health outcomes

A randomized experimental test of the implementation feasibility and the efficacy of a culturally adapted Parent Management Training intervention was conducted with a sample of 73 Spanish-speaking Latino parents with middle-school-aged youth at risk for problem behaviors. Intervention feasibility was evaluated through weekly parent satisfaction ratings, intervention participation and attendance, and overall program satisfaction. Intervention effects were evaluated by examining changes in parenting and youth adjustment for the intervention and control groups between baseline and intervention termination approximately 5 months later. Findings provided strong evidence for the feasibility of delivering the intervention in a larger community context. The intervention produced benefits in both parenting outcomes (i.e., general parenting, skill encouragement, overall effective parenting) and youth outcomes (i.e., aggression, externalizing, likelihood of smoking and use of alcohol, marijuana, and other drugs). Differential effects of the intervention were based on youth nativity status.     

The short‐term impact of a problem‐solving skills programme for Iranian parents

Background: The ability of children to solve problems is an important influence on the social‐cognitive development of children. Parents and children who use problem‐solving strategies display more positive parent‐child relationships. It follows that parents will be more effective in promoting the children's development and healthy parent‐child relationships if they are skilled in problem‐solving strategies and encourage their children to use these strategies. Aim: The aim of the present study was to evaluate the short‐term efficacy of a problem‐solving skills program for Iranian parents (the ‘Raising a Thinking Child’ program) on the parent‐child relationship. Materials and method: Sixty‐four mothers of 4–8 year‐old children participated voluntarily in 12 2‐hour weekly workshops over a three month period. Parents were taught a procedure for problem‐solving and provided with the opportunity to consider how the procedure could be applied in response to challenging behaviors of their children. The problem‐solving strategies were taught as an alternative to ineffective approaches such as punishing and reprimanding. Results: Results indicated that teaching problem‐solving skills to parents had a positive influence on a number of dimensions of parenting as measured by the Parent Child Relationship Inventory. Conclusion: Parents who attended the program felt more supported, more involved with their children and better able to balance limit setting and child autonomy.