Distilling Common History and Practice Elements to Inform Dissemination: Hanf-Model BPT Programs as an Example

Abstract

There is a shift in evidence-based practice toward an understanding of the treatment elements that characterize empirically-supported interventions in general and the core components of specific approaches in particular. The evidence-base for Behavioral Parent Training (BPT), the standard of care for early-onset disruptive behavior disorders (Oppositional Defiant Disorder and Conduct Disorder), which frequently co-occur with Attention Deficit Hyperactivity Disorder, is well-established; yet, an ahistorical, program-specific lens tells little regarding how leaders, including Constance Hanf at the University of Oregon, shaped the common practice elements of contemporary evidence-based BPT. Accordingly, this review summarizes the formative work of Hanf, as well as the core elements, evolution, and extensions of her work, represented in Community Parent Education (COPE; Cunningham, Bremner, & Boyle, 1995; Cunningham, Bremner, Secord, & Harrison, 2009), Defiant Children (DC; Barkley 1987; Barkley, 2013), Helping the Noncompliant Child (HNC; Forehand & McMahon, 1981; McMahon & Forehand, 2003), Parent-Child Interaction Therapy (PCIT; Eyberg, & Robinson, 1982; Eyberg, 1988; Eyberg & Funderburk, 2011), and the Incredible Years (IY; Webster-Stratton, 1981; 1982; 2008). Our goal is not to provide an exhaustive review of the evidence-base for the Hanf-Model programs; rather, our intention is to provide a template of sorts from which agencies and clinicians can make informed choices about how and why they are using one program versus another, as well as how to make inform flexible use one program or combination of practice elements across programs, to best meet the needs of child clients and their families. Clinical implications and directions for future work are discussed.

Psychological Treatments for the World: Lessons from Low- and Middle-Income Countries

“…Based on several studies (Chorpita & Daleiden 2009, Chorpita et al 2007), the recent IOM report (England et al 2015) called for identifying the therapeutic elements that are common across effective psychological treatments. Such an approach lies at the heart of some transdiagnostic treatments in which a set of common elements can be delivered in varying combinations to address diverse mental health conditions (Farchione & Bullis 2014, Kaehler et al 2016, McHugh et al 2009). Transdiagnostic treatments may be particularly suitable for CMDs because these disorders share genetic, familial, and environmental risk factors (Kendler 1996, Kessler et al 2005) and, unsurprisingly, are often comorbid conditions (Brown et al 2001).…”

Research Review: Harnessing the power of individual participant data in a meta‐analysis of the benefits and harms of the Incredible Years parenting program

“…Incredible Years is largely similar in content to many other established parenting programs (Kaehler, Jacobs, & Jones, 2016; (Leijten, Melendez-Torres, Knerr, & Gardner, 2016). We considered the following outcomes as potentially beneficially or adversely affected by the program:…”

What are the Optimal Combinations of Parenting Intervention Components to Reduce Physical Child Abuse Recurrence? Reanalysis of a Systematic Review using Qualitative Comparative Analysis

“…Once the interventions had been categorised as most effective or least effective, we then labelled the interventions for the presence or absence of key intervention components that, based on prior theoretical and conceptual understandings, we expected could be of importance in understanding pathways to effectiveness. Our coding scheme was hierarchical in nature (see Table ), and informed by prior theoretically led component schemes used in similar systematic reviews and component analyses of social learning theory‐led parenting interventions (Garland et al, ; Kaehler et al, ; Kaminski et al, ). Upon inspection of the resultant data table, we focused on our analysis by identifying a set of components that were theoretically salient, represented multiple aspects of social learning theory and showed enough variation in their presence versus absence across the included studies to render analysis possible.…”

“…Second, we described proactive parenting strategies as techniques such as monitoring and providing clear, brief, positive commands that parents could use to prevent difficult parenting situations. These first two components are hallmarks of social learning theory‐based parenting interventions (Kaehler et al, ). Third, we described attachment‐focused strategies as the presence of additional strategies to aid parents in developing more secure bonds with their children.…”