A Pilot Study of the Feasibility and Efficacy of the Strategies to Enhance Positive Parenting (STEPP) Program for Single Mothers of Children With ADHD

Abstract

Objective: The Strategies to Enhance Positive Parenting (STEPP) program was developed to address putative factors related to poor engagement in and outcomes following traditional behavioral parent training (BPT) for single mothers of children diagnosed with ADHD. Method: Twelve single mothers of children with ADHD were enrolled in an initial investigation of the feasibility and preliminary efficacy of the 9-week STEPP program. Results: Results indicated that the STEPP program was effective in reducing problematic child behavior and improving parental stress and psychopathology at posttreatment. The STEPP program resulted in high rates of treatment attendance and completion and consumer satisfaction with the program. However, results also indicated that the STEPP program did not improve childrens' overall psychosocial impairment and resulted in small effect size findings across measures. Conclusion: The results of the pilot study are encouraging but indicate a need to improve the potency and delivery of certain aspects of the STEPP program. ( J. of Att. Dis. 2008; 12(3) 270-280)

Enhancing Traditional Behavioral Parent Training for Single Mothers of Children with ADHD

“…The STEPP program, however, also includes several enhancements to the format, delivery, and content of traditional BPT based on the extant literature (Chacko et al, 2008). First, the STEPP program incorporates an enhanced intake procedure that improves parents' motivation to engage in treatment, addressing possible practical barriers to treatment participation, and addressing maternal cognitions regarding expectations for treatment and attributions regarding their child's behavior (McKay, Stoewe, McCadam, & Gonzales, 1998;Morrissey-Kane & Prinz, 1999;Nock & Kazdin, 2005;Prinz & Miller, 1996).…”

“…Only three relatively small BPT studies have been conducted with this population-one with single mothers of children with elevated levels of behavior problems (i.e., Pfiffner, Jouriles, Brown, Etscheidt, & Kelly, 1990), one with single parents (mothers and fathers) of children with ODD=CD (Dadds & McHugh, 1992), and finally one study investigating the feasibility and preliminary efficacy of the Strategies to Enhance Positive Parenting (STEPP) program targeting single mothers of children diagnosed with ADHD (Chacko et al, 2008). Pfiffner and colleagues (1990) randomly assigned 13 single mothers of children with elevated levels of behavioral problems to either traditional BPT or traditional BPT plus a problem-solving treatment.…”

“…To our knowledge, only one small, uncontrolled study has investigated the efficacy of an enhanced BPT intervention targeting single mothers of children specifically diagnosed with ADHD, ODD, or CD (Chacko et al, 2008). Chacko and colleagues evaluated the efficacy of the STEPP program, which included several adjunctive components addressing key areas influencing treatment engagement and outcomes for single mothers participating in BPT.…”

Viewing Preschool Disruptive Behavior Disorders and Attention-Deficit/Hyperactivity Disorder Through a Developmental Lens: What We Know and What We Need to Know

“…97,98 Although multiple reasons have been posited, we note that the lack of developmental specification of DBD and ADHD symptoms potentially undermines the efficacy of BPT and other interventions (e.g., stimulant medication). For example, we noted earlier that noncompliance per se is not pathognomic but can be adaptive and developmentally appropriate for preschoolers.…”

Family Support in Children’s Mental Health: A Review and Synthesis

“…Barrett et al (1996) 3. The STEPP Program (Strategies to Enhance Positive Parenting) Chacko et al (2008Chacko et al ( , 2009 4. CBT?PAM (Cognitive Behavioral Therapy?…”