Applied parent interventions Flashcards
What was the most common way to tackle disruptive behaviour in children before the 1960s?
Behavioural parenting interventions
What happened in the case of rusty? - Boardman 1962
Parents wanted help for their sons disruptive behaviours such as climbing on roof, playing w matches, being oppositional
Boardman had an idea of working w parents to help them manage rusty’s behaviour and change how they responded to the behaviour - led to a reduction in disruptive behaviour
This empowers & ‘upskills’ parents to manage their child’s behaviour - builds parental confidence - they become agents of change for their children
Coercive process theory - patterson & reid 1970
1.Parent issues child with a demand
2. Child engages in challenging behaviour
3. Parent removes demand
4. Child behaviour is -vly reinforced
5. Parent issues child w a demand
6. Child engages in challenging behaviour
7. Parents persist
8 Child behaviour escalates
9. Parent responds w harsh discipline & removes task
10. Via social learning child also learns that harsh
discipline may be an effective way to deal w conflict
11. Child engages in challenging behavior w teacher &
peers
Why is the child’s behaviour strengthened & the chances of them doing it again increased?
Because the behaviour is negatively reinforced
Via the coercive process how does behaviour become a -ve behaviour cycle?
Child = will start at a young age and happen w multiple interactions of -ve reinforcement
- behaviours may then start to generalise into another setting w yeachers, peers
How is the -ve behaviour cycle reinforced?
A psychologist whi is intervening = to try and disrupt process, so the cycle = broken = where we see real change for the child
Parental programmes = reccomended when?
As the first line of treatment approach for children showing oppositionla and externalising behaviouts e.g. a children w diagnoses of oppositional defiant or adhd
How does triple p parenting enhance family protective factors and reduce risk factors?
- encourages +ve interactions between parents & children e.g. games, songs, activities
- teaches parents an alternative rather than coercive parent behaviours e..g time out, planned ignoring, child not recieving enough reinforcement
- +ve reinforcement of adaptive behaviour e.g token economy = star reward chart so gets a reward at the end of the week
What is triple p parenting programme?
Aims to treat (prevent also) behavioural problems in young children & enhances family protective factors & reduce risk factors
Why are parenting programmes goof?
Because behaviours often emerge in very young vchildren so = difficult to sit down w them themselves = children may not have the cog skills to recognise / understand their own emotions - so the parents become co therapists & agents of change as they = too involved w their children
How many sessions in the triple p parenting programme is there?
10
What is enhanced triple p
= has more learning outcomes/modules for families who have additional risk factors/ adversity e.g parents separation
= communication to help parents communicate and manage the impact of seperation in their child
Does triple p work?
in research, can assess the effects of interventions using randomised controlled trials RCTs = a gold standard way to assess wether interventions is effective
Bor, sanders & markie-dadds 2002 - what was the aim?
To compare effectivness of enhanced triple p, standard triple p and no treatment control (waitlist control)
Bor, sanders & markie-dadds 2002 - what was the methods?
87 families of children aged 3 w elevated levels of disruptive behaviour and symptoms of inattention / hyperactivity, randomised to diff treatment conditions = assessed at baseline, post intervention and long term follow up (one year)
Bor, sanders & markie-dadds 2002 - what was the results?
Both standard and enhanced intervations led to reductions in parent-reported behaviour problems compared to control group, enhanced triple p also led to reductions in observed -ve child behaviour
Bor, sanders & markie-dadds 2002 - what was the conclusion?
Both standard & enhanched triple p are effective interventions for disruptive child behaviours
What is a meta analysis?
- Most reliable evidence base for clinical practice and research
- Calculate an overall effect using data from existing data
A meta-analysis of the triple p parenting programme - sanders et al 2014
- Combined data from 101 studies (62 RCTs) that have explored the effectiveness of triple p parenting programme
- Studies shows all levels of triple p = eeffective for child behaviour problems (internalising & externalising)
- Smaller effect sizes when looking at observed child behaviour compared to parent-report
- Triple p is also effective for parenting practices, parenting satisfaction, parenting efficacy
What happens as children get older?
- Interventions may not be so parent-focused as children get older e.g. triple p using for younger children
- Child variables are important but = so are wider societal factors such as peers and wider community influences
- Multi-systematic therapy for older children - addresses multiple risk fsctors
- Older children may also be access cog beh techq for emotion regulation - developing awareness of their emotions
What is The New Forest Parenting Programme for Children w ADHD
- a specialised intervention for parents of young children w adhd
- build on approaches used in trad beh parenting interventions
What does N.F.P.P do?
- targets parent-child processes involved in the development of attention and self-organising skills
—> gives child the skill regulate more effectively in diff situations - children w adhd have difficulty maintaining their attention on day to day tasks - programme helps parents to come up w ways to help children complete day to day tasks
How long are the N.F.P.P sessions/
8 sessions - 1hr each
Children w ADHD may have problems with what?
STM
What would be an example of helping develop a childs STM?
pairing cards
What is the process of constrictive?
Scoping - working out what a child’s current level of ability is
Extending - deciding how to extend skills
Scaffolding - learning new skills via games / procedures
Consolidation - practice & extend skills in real world
What is evidence for the the N.F.P.P
- has been tested in a number of randomised controlled trials
- parents randomised to recieve NFPP (n=20), no treatment (n=30) or to a parent support and counselling group (n=28)
- assessments completed pre-intervention, post-intervention (week 8), long term follow up (week 23)
How are variables measured? - ADHD symptopms
Clinical interview & observation
How are variables measured? - Parental mental health
Parent self-reported
N.F.P.P EV
= tailored to ADHD
- abikoff et al = conducted a head to head trial of NFPP = ‘helping the noncompliant child’ = another parenting programme
How were the ppts asseses - abikoff et al
- Parent and teacher reported adhd symptoms
- parent behaviour and parent stress
- objective measures of impulsivity and sustained attention - self report, parent report
What were the findings of NFPP v HNC
NFPP & HNC = led to reductions in parent reported adhd symptoms no superior effect of NFPP
NFPP = may not effectively alter the processes thought to underlie adhd
BOTH = effective but not more than the other
If NFPP = based on theory - why is it not better than oter beh interventions?
the cog component in NFPP = not intensive enough
may need to combine diff aspects of executive func = not all children w adhd show wmm deficits
adhd = chronic disorder
more research = needed in this area
What has been less of a focus in models of childhood anx
parent beh = less of a focus in models of childhood anxiety
What = main treatment for anxiety in youth in cog beh therapy?
CBT
What are the components of CBT children?
- monitoring
- cognitive restructuring
- exposure
- skills dev
What is monitoring?
wanting children to notice and label their emotions accurately
What is cog restructuring?
working on thoughts children may have on specific situations, helping child see situation in a diff way
What is exposure?
Where child avoids situations that they = fearful of = try to reduce that over days/weeks
What is skills dev?
developing skills & understanding rules of social interaction, working on skills that = help the in these situations
How may parents be involved?
- Parental modelling of anxiety
- Parental cognitions
- Overprotection
What is parental modelling of anxietyy?
working w parents may help encourage them to reduce the amount of anxiety they portray to their child = if they have fearful response to situation can evoke fearful response in child
What is parental cognitions?
may impact the way children think about situations e.g if parents think bad things happen in public transport, child can pick up on that & they think the same
What is overprotection (in this context)?
Limits the amount of time/opp the chiild = had w activities outside comfort zone, children need this to be confident & grow as individuals, overprotection can get in the way of them getting over fears
What is F.E.A.R
F = feeling frightened = identifying (monitoring componenet of cbt)
E = expecting a bad thing to happen = looking at thouughts and cognitions relating to emotions
A = Actions & attitudes = how did emotions impact their actions, encouraged to try out new actions
R =Results & Rewards Montored results
= targeted parental beliefs = helping parets see anxiety provoking situations in diff ways up-skilling parents to up skill thier chld
A study was done to compare what?
Individual CBT
Family based CBT
Family based education and support
What were te findings of the comparison study?
Results showed there was little diff about parental involvement as both condition 1 & 2 = 64% children ‘lost’ primary anxiety diagnosis
In contol group = only 42% ‘lost’ primary anxiety diagnosis
Silk et al study consisted of?
- Child = asked to give speech for 1.5 mins
- Parents & child = plan speec together for child to deliver sppech
- Another optional speech afterwards - key component
Parents who had anxious children were …
less likely to encourage their children to do the speech
Parents who take part in CBT are more likely to engage in…
encouragement after their involvemnt in their intervention (child face fears and = brave)
Process of a child talking part in cbt = likely yo have an influence on…
parent beh and leading to child maximising the gains they recieve from the interv
Parent only interv = study by who?
lebowittz et al 2020
What did lebowitzz et al do?
Compared individual CBT w SPACE (supporting parenting for anxious child emotions)
What were the individual CBT sessions studied by Lebowitzz like?
- 12 weekly 60 min sessions
- Exposure based hierarchy
- identifying & Challenging -ve cognitions
- Adapting cognitions
What were the SPACE sessions studied by Lebowitzz like?
- 12 weekly 60 min sessions
- Supportive responses to child anxiety
- Reduce accommodation and avoidance
- How to communicate to child
- How to deal w child responses
parents who were involved in SPACE learnt all these techqniques to…
be involved +vly w their child
What does SPACE focus on?
up skilling parent in what to do w their child in diff situations
What were lebowitzz’s findings?
- no diff in outcomes between child CBT & SPACE
= indication there may be real benefits in working w parents alone specifically w those w young children who cannot engage in individual CBT themselves
Which components of interventions = neccessary?
cbt = effective doesnt work for everyone
Who did a meta analysis of existing cbt interventions for childhood anxiety & what did they find?
Whiteside et al 2020 & Found that exposure = most important componant of intervention
