Benefits of Child Behavior Interventions for Parent Well‐Being
| Published date | 01 December 2018 |
| Date | 01 December 2018 |
| Author | Marion Forgatch,Truls Tømmerås,John Kjøbli |
| DOI | http://doi.org/10.1111/fare.12344 |
T T Norwegian Center for Child Behavior Development, Oslo, Norway
J K Regional Center for Child and Adolescent Mental Health, Oslo, Norway
M F Oregon Social Learning Center, Eugene, OR
Benets of Child Behavior Interventions for Parent
Well-Being
Objective: To explore the direct and indirect
associations among GenerationPMTO (i.e., the
“Oregon model” of a parent management train-
ing program), childbehavior problems, and par-
ent outcomes.
Background: The behavioral parent train-
ing program GenerationPMTO is designed to
improve child behavior outcomes. Although
parent well-being is not targeted, previous stud-
ies have found collateral benets on parental
well-being for GenerationPMTO in preventive
low-risk samples and high-risk samples.
Method: Bootstrapped structured equation
models were used to analyze 2 randomized trials
that evaluate parent well-being (mental health,
somatic health, and vitality) in 2 versions of
GenerationPMTO: Brief Parent Training (BPT)
for a preventive sample (N=216) and Gener-
ationPMTO, which was higher-risk and a mix
of a clinical and a preventive sample (N=137).
We examined direct and indirect effects of
treatment condition for parent well-being via
change in children’s behavior problems, change
in parenting practices, and level of parenting
self-efcacy.
Norwegian Center for Child Behavior Development,
P.O. Box 7053 Majorstuen, 0306 Oslo, Norway (trul-
stom@nubu.no).
Key Words: Child behavior problems, early intervention,
evidence-based parenttraining, family processes, social risk.
Results: Six months after treatment, results
revealed positive effects on targeted child and
parent outcomes in both samples, whereas only
the BPT intervention had direct effects on parent
well-being.
Conclusion: Collateral benets in the low-risk
BPT sample suggest that helping children and
their families at earlier stages of negative devel-
opment may increase the potential for immediate
collateral benets.
Implications: The results highlight the preven-
tive potential of a brief behavioral parent train-
ing intervention based on the social interaction
learning model.
Parent and child well-being are closely inter-
twined (Glied & Oellerich, 2014). Poor parent
well-being (e.g., mental health, somatic health,
and vitality) is associated with negative conse-
quences for children’s mental health in general
(Shonkoff et al., 2012) and behavior problems in
particular (i.e., conduct problems, oppositional
problems, and attention problems; Haskins,
Garnkel, & McLanahan, 2014). Furthermore,
when children are unhealthy, the well-being
of their parents and other family members
suffers (Aneshensel, Phelan, & Bierman, 2013;
Corcnan, Noonan, & Reichman, 2005). In effect,
family members’ adjustment seems to be inter-
connected. The present study evaluates the rela-
tionship between children’s behavior problems
and parent well-being following an intervention.
644 Family Relations 67 (December 2018): 644–659
DOI:10.1111/fare.12344
Benets of Child Behavior Interventions 645
Evolving since the 1960s, evidence-based
behavioral parent training interventions (here-
after, “parent training interventions”) have been
found to produce favorable targeted health
care outcomes for children by relieving behav-
ior problem symptoms (Dishion, Forgatch,
Chamberlain, & Pelham, 2016; Forgatch &
Kjøbli, 2016; Lundahl, Risser, & Lovejoy, 2006;
Reyno & McGrath, 2006). That said, for inter-
ventions to have prolonged effects on children’s
positive development, scholars stress the need to
address underlying risk factors that accompany
mental health problems (Chase-Lansdale &
Brooks-Gunn, 2014; Haskins et al., 2014), such
as diminished parent well-being. Research on
parent training inventions commonly evaluates
outcomes such as change in child behavior and
change in parenting practices. Less attention
has been given to evaluate collateral benets
on parent well-being, such as parent somatic
health, mental health, and feeling of vitality. In
this article, the term collateral benet denotes
benecial outcomes that are not specically
targeted in treatment. When one improves
the immediate needs of children experiencing
behavior problems, are there collateral benets
on parent well-being? If so, this would suggest
that parent training interventions can affect
underlying social risk factors that are associ-
ated with behavior problems and several other
negative developmental outcomes for children
(Bornstein & Bradley, 2014; Caspi et al., 2016).
If parent training interventions have effects
beyond children’s behavior problems, public
health benets may have been underestimated
(Dishion et al., 2014).
The family is considered as a particularly
important arena to promote young children’s
development (Frønes, 2016; Haskins et al.,
2014). In parent training interventions, par-
ents are the agents of change in their children
(Kaehler, Jacobs, & Jones, 2016). Thus, the
essence in parent training is to support and
strengthen the family environment and parent-
ing practices, which is an important factor to
support healthy child development in general
and behavior problems in particular (Capaldi,
DeGarmo, Patterson, & Forgatch, 2002; Caspi
et al., 2016). In GenerationPMTO (formerly
known as Parent Management Training—the
Oregon Model) and similar behavioral par-
ent training programs (e.g., the Incredible
Years [Webster-Stratton, 2000] and Triple P
[Sanders, Markie-Dadds, Tully, & Bor, 2000]),
the primary aim is to relieve child problems
by strengthening parenting practices, not to
address parent well-being. Accordingly, the
GenerationPMTO program should be a suit-
able intervention context to examine collateral
benet on parent well-being.
There is substantial agreement that the
link between parent well-being and behavior
problems in children relates to family stress
processes (Capaldi et al., 2002; Conger, Conger,
& Martin, 2010). For example, Conger, Ge,
Elder, Lorenz, and Simons (1994) found that
family economic hardships were followed by
disrupted and harsh parenting style, which in
turn predicted emotional and behavior problems
in children. A meta-analysis has been conducted
on the family stress hypothesis and how dimin-
ished family resources affect child outcomes via
increasing family stress, which in turn disrupts
parenting practices (e.g., less nurturing and
positive parenting; more use of inconsistent and
harsh parenting; Conger et al., 2010). Lack of
parental social resources has been found as well
to align with the family stress hypothesis. For
example, parents’ depression is associated with
delays in children’s cognitivedevelopment and a
much greater risk of behavior problems (Dennis
& Hodnett, 2007). Thus, diminished parent
well-being is considered as a family stressor
that inuences the development of behavior
problems (Bank, Forgatch, Patterson, & Fetrow,
1993; Glied & Oellerich, 2014). Moreover,
there are also indirect relations between family
resources and negative effects in other adult
domains, such as marriage and family func-
tioning, work, and social network, which may
add additional stress to the family environment
and disrupt parenting practices (Patterson, For-
gatch, & DeGarmo, 2010; Rishel, 2012). Taken
together, it seems that parents from high-risk
families marked by low access to social and
economic resources more often struggle with
daily challenges that increase family stress lev-
els and thereby reduce their ability to socialize
their children using positive parenting practices.
GenerationPMTO interventions are based on
the social interaction learning model (Forgatch
& Patterson, 2010). This model complements
the family stress hypothesis by offering a
microsocial explanation that highlights the
mechanism that explicates how the paths from
social risk (and individual risk) to children’s
behavior problems occur in families—namely,
the coercion mechanism (Patterson, 2002).
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