Parent Management Training and Collaborative & Proactive Solutions: A Randomized Control Trial for Oppositional Youth

Abstract

Objective Examine the efficacy of Collaborative & Proactive Solutions (CPS) in treating oppositional defiant disorder (ODD) in youth by comparing this novel treatment to Parent Management Training (PMT), a well-established treatment, and a waitlist control (WLC) group. Method One hundred and thirty four youth (ages 7 – 14, 61.9% male, 83.6% white) who fulfilled Diagnostic and Statistical Manual of Mental Disorders (4th ed.) criteria for ODD were randomized to either CPS, PMT or WLC groups. ODD was assessed with semi-structured diagnostic interviews, clinical global severity and improvement ratings, and parent report measures. Assessments were completed pre-treatment, post-treatment, and at 6 months following treatment. Responder and remitter analyses were undertaken using intent-to-treat mixed models analyses. Chronological age, gender, and socioeconomic status as well as the presence of comorbid attention deficit/hyperactivity and anxiety disorders were examined as predictors of treatment outcome. Results Both treatment conditions were superior to the WLC condition but did not differ from one another in either our responder or remitter analyses. Approximately 50% of youth in both active treatments were diagnosis free and were judged to be much or very much improved at post-treatment, compared to 0% in the waitlist condition. Younger age and presence of an anxiety disorder predicted better treatment outcomes for both PMT and CPS. Treatment gains were maintained at 6-month follow-up. Conclusions CPS proved to be equivalent to PMT and can be considered an evidence-based, alternative treatment for youth with ODD and their families.

Cognitive Behaviour Therapy for Children and Adolescents: Can Attachment Theory Contribute to Its Efficacy?

“…However, an increasing number of studies and meta-analyses suggest that adding PFT to CFT does not significantly improve treatment effects, again, independent of the targeted problem (e.g. Dowell and Ogles 2010;Eimecke et al 2010;Ollendick et al 2015;Silverman et al 2008;Thulin et al 2014). These findings were surprising because the clinical impression exists that involving parents in CFT ought to be beneficial (e.g.…”

“…Also, research on the effect of PFT on children's externalizing problems suggests that PFT effects decline when the targeted children are older (e.g. Kazdin 1995;Ollendick et al 2015).…”

Behavioral Interventions for Anger, Irritability, and Aggression in Children and Adolescents

“…On the other hand, disruptive behavior may reduce compliance with psychosocial interventions for internalizing symptoms and contribute to functional impairments conferred by the primary diagnoses (Garcia et al 2010). Children with elevated symptoms of anxiety/depression demonstrate greater gains following treatment with parent training (Ollendick et al 2015) and CBT for aggressive behavior ( Jarrett et al 2014). It has been suggested that a combination of permissive and controlling/ hostile parenting styles may contribute to co-occurring anxiety and conduct problems (Granic 2014) and parent-focused treatments have been increasingly used for treatment of anxiety in children (Forehand et al 2013).…”

Emotion Socialization in the Context of Risk and Psychopathology: Maternal Emotion Coaching Predicts Better Treatment Outcomes for Emotionally Labile Children with Oppositional Defiant Disorder

“…In each treatment, both children and parents participate to facilitate parents’ mastery of skills. In this randomized controlled trial, equivalence of outcomes between the two treatments was demonstrated (Ollendick et al, 2014). …”

“…The present study enrolled families seeking treatment for their child's ODD symptoms (Ollendick et al, 2014). Families were randomly assigned to one of two treatment conditions: Parent Management Training (PMT: Barkley, 1997) or Collaborative and Proactive Solutions (CPS: Greene, 1998, 2010).…”