Treatment Outcomes and Mediators of Parent Management Training: A One-Year Follow-Up of Children with Conduct Problems

Abstract

This effectiveness study presents the results of a 1-year follow-up of a randomized controlled trial of Parent Management Training. Families of 112 Norwegian girls and boys with clinic-level conduct problems participated, and 75 (67%) families were retained at follow-up. Children ranged in age from 4 to 12 at intake (M = 8.44). Families randomized to the control group received an active treatment alternative as would be normally offered by participating agencies. Multi-informant, multisetting outcome measures were collected and results from both intention-to-treat and treatment-on-the-treated analyses are presented. In two separate indirect effects models, assignment to Parent Management Training-the Oregon model predicted greater effective discipline and family cohesion at postassessment, which in turn predicted improvements in several child domains at follow-up.

Multiple Family Groups for Children with Disruptive Behavior Disorders: Child Outcomes at 6-Month Follow-Up

“…The current study, moreover, extends findings from the smaller clinical trials by reporting maintenance of treatment gains for ODD and improvements in certain functional domains (e.g., relationship with playmates or peers, overall severity of child problems and need for treatment) at 6-month follow-up. Such findings are also consistent with the maintenance of treatment effects from post-test to follow-up assessment periods for similar parent management training programs tested within routine clinic settings (e.g., Axberg and Broberg 2012; Behan et al 2001; Costin and Chambers 2007; Gardner et al 2006; Hagen et al, 2011; Hautmann et al 2009; Kleve et al 2010; Kling et al 2010; Kjobli and Ogden 2013; Larsson et al 2009; Ogden and Hagen 2008). …”

“…Specifically, Kjobli and Ogden (2013) found statistically significant small to medium (i.e., 0.39–0.47) effect sizes in reduction of child behavior difficulties at 6-month follow-up using ITT analyses. Hagen et al (2011) reported no significant between-group differences on analyses including 1-year follow-up measures on child behavior outcomes using ITT analyses, and only small effect sizes (i.e., 0.08–0.29) among those who actually received treatment. Effect sizes for between group analyses in the current study are also consistent with those reported (average d = 0.30) by Lee et al (2013) in their analysis of 13 effectiveness studies conducted in routine clinic settings for treating youth DBDs.…”

“…The current effectiveness study focuses on the extent to which a treatment can work in applied practice settings. In comparison to other effectiveness studies focused on treatment of youth with behavior disorders in community settings (Axberg and Broberg 2012; Behan et al 2001; Costin and Chambers 2007; Gardner et al 2006; Hagen et al 2011; Hautmann et al 2009; Kleve et al 2010; Kling et al 2010; Kjobli and Ogden 2013; Larsson et al 2009; Ogden and Hagen 2008), the current study is unique as it has been conducted within typical inner-city community child mental health clinics within the US with a predominantly low-income sample.…”

“…Several recent effectiveness studies utilizing variations of parent management training approaches to treat DBDs in community settings document that treatment gains can be maintained on child disruptive behavior at 6 months (e.g., Behan et al 2001; Costin and Chambers 2007; Gardner et al 2006; Kling et al 2010; Kjobli and Ogden 2013), 12 months (e.g., Axberg and Broberg 2012; Hagen et al 2011) or longer (e.g., Gardner et al 2006; Weisz et al 2012) follow-up assessments. Studies that have evaluated social competence have also revealed maintenance of gains on these outcomes (e.g., Hagen et al 2011; Kjobli and Ogden 2013). Consequently, in the current study, we hypothesize benefits associated with MFG found at post-treatment on disruptive behavior and social competence will be at least maintained at the 6-month follow-up assessment.…”

Parent Management Training-Oregon Model (PMTO™) in Mexico City: Integrating Cultural Adaptation Activities in an Implementation Model

“…The intervention has been implemented statewide in Michigan and Kansas (Forgatch et al, 2013), and nationwide in Norway, Iceland, Denmark, and The Netherlands (e.g., Bekkema, Wiefferink, & Mikilajczak, 2008; Ogden, Forgatch, Askeland, Patterson, & Bullock, 2005; Ogden, Hagen, Askeland, & Christensen, 2009; Sigmarsdóttir & Björnsdóttir, 2012; Sigmarsdóttir & Guđmundsdóttir, 2012). In all these instances, fidelity is carefully monitored to prevent drift (Forgatch & DeGarmo, 2011; Sigmarsdóttir & Guđmundsdóttir, 2012), and notable improvements in child and parent outcomes have been found (Hagen, Ogden, & Bjørnebekk, 2011; Sigmarsdóttir et al, n.d.). The intervention has been culturally adapted for use with ethnic minorities in the United States (Domenech Rodríguez et al, 2011; Parra-Cardona et al, 2012) and Norway (Bjørknes, Kjøbli, Manger, & Jakobsen, 2012).…”