Exploring the role of natural helpers in efforts to address disparities for children with conduct problems

The incorporation of natural helpers into services has been suggested as an innovative strategy to address disparities for historically underserved children with conduct problems. In order to inform incorporation efforts, this study examined the perceptions of natural helpers serving one U.S. Latina/o community regarding need for services for children with conduct problems, their reactions to a specific parent training intervention, and the training and support needed to deliver this intervention successfully. Participants identified a need for culturally-responsive services for children with conduct problems, and felt that parent training would be appropriate for the families they serve. Participants further identified specific training and support that they would require in order to deliver parent training with fidelity and effectiveness. Findings support the suggestion that natural helpers have the potential to address service disparities among Latina/o children with conduct problems. Recommendations from natural helpers should guide the development of culturally-adapted preventive interventions that help address existing service disparities.     

Outcomes of Parent–Child Interaction Therapy in an urban community clinic: A comparison of treatment completers and dropouts

This study examined outcomes of Parent–Child Interaction Therapy (PCIT) for 52 clinically referred children with oppositional behavior and their parents treated in an urban, community mental health clinic serving demographically (i.e., income level, ethnicity) diverse families. Standardized observations of parent–child interactions and parent reported measures of child behavior were collected at pre- and post-treatment. We addressed two primary research questions: (1) What are pre-treatment predictors of treatment completion? (2) What are treatment outcomes both for families who successfully completed PCIT and for treatment dropouts? Multiple logistic regression results showed a significantly greater likelihood of treatment completion related to higher parent education, male child gender, and two parent households. Among families who completed treatment, pre–post data demonstrated significant parent change in observed skill use and improvement in parent reported disruptive behaviors with medium to large effect sizes. Findings also documented early treatment benefits for families who completed the first phase of PCIT but dropped out in the final phase prior to meeting full graduation criteria. We discuss the findings and implications for community-based applications of PCIT in the context of community mental health's mission to provide effective treatment and maximize community access to services.     

Dissemination of an evidence-based parenting program: Clinician perspectives on training and implementation

The present study used a qualitative approach to examine clinicians' experiences as trainees of an evidence-based parenting program, parent–Child interaction therapy (PCIT). In order to explore factors related to successful implementation and maintenance of the PCIT program in a community setting, twenty-nine community clinicians completed phone interviews six months to four years after an initial forty-hour PCIT training workshop. Clinicians reported positive experiences with the training, but also described barriers related to agency, client, program, and training factors. Findings suggest that (1) trainees view the core components of PCIT as acceptable and valuable, (2) training costs and problems with third-party reimbursement can impede implementation, (3) clinicians may benefit from training that includes skills in motivation enhancement, and (4) ongoing consultation is valuable to clinicians, although trainees differ in their preferences regarding the manner of delivery (e.g., teleconference, live). This study brings clinicians into the conversation regarding barriers to and facilitators of evidence-based training and implementation.     

Incorporating natural helpers to address service disparities for young children with conduct problems

In response to the high levels of unmet need among historically underserved young children with conduct problems, this paper outlines some of the key issues involved in incorporating natural helpers into the delivery of parenting interventions for the treatment of conduct problems among historically underserved children. Strategies for the selection and training of natural helpers are discussed along with challenges that might be encountered in these processes. Directions for future research are also highlighted. With appropriate selection and training procedures in place, natural helpers may increase the accessibility of services for children and families and foster the reduction of service disparities.     

Risk factors for attrition from an evidence-based parenting program: Findings from the Netherlands

Parent management training programs for the treatment of childhood conduct problems are increasingly being transported from their country of origin to international settings. Family interactions, however, may be influenced by different cultural expectations and children's mental health problems may be addressed within different systems. Demonstrating reductions in symptoms within the new population is insufficient to support the wide-scale transport of a treatment model. Implementation outcomes such as the rates of treatment retention and factors related to treatment attrition must also be considered. We explored predictors of attrition in families from the Netherlands referred to the evidence-based parenting program Parent–Child Interaction Therapy (PCIT). Participants included 40 children with conduct problems (2–7 years; 68% boys) and their caregivers. Attrition (40%) was somewhat lower than findings with similar community samples in the US. Significant predictors of attrition were child age and maternal levels of internalizing symptoms. Low parental demandingness and high child compliance before start of treatment were related to early attrition within twelve treatment sessions. Meeting the needs of families at risk for attrition is an important goal for parent management training programs within and outside the US if families in need of services are to benefit from them.     

Parent-child interaction therapy: application of an empirically supported treatment to maltreated children in foster care

One of the more serious problems faced by child welfare services involves the management of children with serious behavioral and mental health problems. Aggressive and defiant foster children are more likely to have multiple foster care placements, require extraordinary social services resources, and have poor short- and long-term mental health outcomes. Interventions that work with challenging foster children and enhance foster parents' skills in managing problem behaviors are necessary. This article presents the successful results of a single case study examining the application of Parent-Child Interaction Therapy (PCIT) with an aggressive young boy and his foster-adoptive parent. PCIT is a dyadic intervention that has been identified as an empirically supported treatment for abused children and for children with different types of behavioral disruption. The application of PCIT to assist foster parents is a promising direction for child welfare services.     

Meeting the parenting skills needs of neglectful families by training child welfare workers as educators

A training program was devised for selected child welfare workers to conduct parent groups in the Missouri Neglect Demonstration Project. Welfare workers were trained to conduct parent groups that focused on parenting skills, self-advocacy, and social and economic resources. In contrast to case manager referrals, the workshops provided education directly and helped parents to develop resources. One of the goals was to have staff and parents collaborate to improve referral services and resources. The importance of this type of program was demonstrated by a literature review of parent trainings which found that: (a) few programs specifically addressed child neglect; (b) outcome evaluations of programs were scarce; and (c) a national extension study supported topics chosen.     

Predictors of treatment attrition and treatment length in Parent‐Child Interaction Therapy in Taiwanese families

Parent–Child Interaction Therapy (PCIT) has been used successfully in the United States and in other countries around the world, but its use in Asian countries has been more limited. The present study is the first of its kind to examine the predictors of treatment attrition and length in a sample of Taiwanese caregivers and their children. It is also the first to examine PCIT outcomes in Taiwanese families. Maladaptive personality characteristics of the caregiver were the best predictor of attrition, followed by single-parent, removal of the child from the home, and lower levels of caregiver education. Treatment length was predicted by child minority status and parent–child interactions (i.e., parent commands and negative parent talk). In terms of outcomes, statistically significant treatment changes were noted for all treatment outcome variables at post-treatment and at 3-month follow-up. These findings suggest that PCIT is a promising intervention for this population. The predictors of treatment attrition and length can be used when Taiwanese caregiver–child dyads present for services so that additional assistance can be provided prior to or during treatment to increase adherence to the recommended number of treatment sessions for maximal impact. Future studies may replicate the present study with a larger clinical sample to examine the long-term effects of PCIT and to include a no-treatment control condition to afford a more robust empirical evaluation.     

Etherapy: A Training Program for Development of Clinical Skills in Distance Psychotherapy

ABSTRACT

This article describes a project by the Virtual Teaching and Cyberpsychology Laboratory of the National Autonomous University of Mexico developed to (1) implement a teaching program for clinical psychology students to learn therapeutic skills in providing online psychological services; (2) evaluate the students' acquisition of knowledge and skills in diagnosis via the Internet, case formulation of treatment, and adherence to treatment protocols; and (3) incorporate technologies for creating training settings and online professional services in order to develop the students' clinical competency in this treatment modality. A pilot study was conducted with 17 clinical psychology students in the first phase of the teaching program and 6 students during the second phase. Preliminary results indicate that students increased knowledge of Internet-based clinical interventions and improved in clinical skills. It is necessary to continue the evaluation of the teaching program with larger samples, and further research is suggested.     

Substance Use Training Experiences and Needs: Findings From a National Survey of Social Care Professionals in England

For more than 30 years there have been calls in the UK to improve training for social workers in relation to substance use. Yet very little research has explored what training practitioners have received or what their training needs are. This study sought to establish practitioners' experiences of previous training in substance use and identify their current training needs. An online survey was disseminated to 3,164 practitioners in adults' (AS) and children's (CS) social care and 12 vignette-based focus groups were also held. Of the final sample of 597, more than a third of social workers had not received any training and a further fifth only received between one and four hours. Other social care staff fared worse. Overwhelmingly, respondents said that substance use knowledge and skills were very important to their practice but their professional education had not prepared them well. They identified a number of training needs including ‘how to talk to people about substance use’ and ‘the types of intervention and treatment available’. Most social care professionals report not being adequately prepared for working with substance use, particularly basic knowledge and skills which would help them to conduct assessments and signpost people to specialist substance services.     

A longitudinal evaluation of government-sponsored job skills training and basic employment services among U.S. baby boomers with economic disadvantages

Job skills training is a cost-effective strategy for improving employment among individuals who have low income and employment barriers, but few U.S. government-sponsored employment program participants have received such training. To better understand long-term gains from job skills training, this study compared employment and earnings trajectories between program participants who received job skills training and those who received basic services only. Using data from the National Longitudinal Survey of Youth 1979, we estimated 33-year employment and earnings trajectories among U.S. baby-boomer cohorts while accounting for baseline group heterogeneity using inverse propensity score weighting. We found increases in employment rates over the life course, especially among Black women. Job skills training also increased earnings by up to 69.6 % compared to basic services only. Despite the long-term gains in employment and earnings, job skills training participation is not sufficient to address gender as well as racial and ethnic gaps in full-time employment. Findings reinforce the importance of incorporating job skills training as an essential service element of government-sponsored employment programs to improve long-term labor market outcomes among Americans with economic disadvantages.     

The effect of caregiver's burden on change in frail older persons' use of formal helpers

We used a national longitudinal probability sample of frail older persons and their caregivers to examine three questions: 1) What are the probabilities of transition to use of formal helpers over a two-year period? 2) What is the role of predisposing, enabling, older person's need, and caregiver's need variables in changes in the use of formal helpers? 3) Do determinants of change in the use of formal helpers vary by level of caregiver's burden? Results show a slight trend to increased use in formal help over time. Personal burden, but not interpersonal burden, had a lagged effect on increased use of formal services. Use of formal helpers was greater in situations combining high levels of older person's need, high levels of caregiver's personal burden, and insufficient support from the informal network.     

Using Parent-Child Interaction Therapy to develop a pre-parent education module

The current study examined outcomes related to a pre-parent education module based on two sessions from the Parent-Child Interaction Therapy (PCIT) treatment protocol. The study included 300 undergraduate non-parents aged 19 to 25 who were enrolled in psychology courses at a large state university. Student knowledge of positive parenting skills and demonstration of effective behavioral parenting skills were examined through a self-report measure and an analog behavior observation. Exposure to the pre-parent education module resulted in significant increases in scores on a PCIT content quiz and frequency of praise during the role-play behavior observation from pre- to post-test. The results of this study suggest that undergraduate non-parents are open, and able, to learn about parenting strategies during a classroom-based parent education module. These findings highlight the feasibility of teaching parenting skills as a preventive strategy during pre-parenthood.     

Effectiveness of refusal skills software

This research explores the potential of making social skills training more accessible to schools by the use of computer-aided instruction. An easy-to-use software program called Refusal Challenges, which targets important social skills with effective training methods, was tested. The dependent measure was demonstration of refusal skills strategies. One-hundred-eighty-eight male and female eighth-grade students were stratified according to pre-treatment refusal skill level, gender, and teacher. They were then randomly assigned from the stratified blocks to either the computer-based refusal skills training group or a control group. Repeated measures analyses of variance indicated a significant and meaningful time by treatment interaction for refusal skills scores. The difference between treatment and control groups remained significant and meaningful at both the post-test and follow-up testing.     

Triangulating perspectives to inform the development of a smartphone application for foster,kinship, and adoptive parents

Abstract

This article describes the initial phase of a user-centered, inductive process for informing the development of a smartphone application (app) to complement an in-person trauma-focused knowledge and skills training class for child welfare resource parents (i.e. foster, kinship, and adoptive parents). Based on the participatory design approach for technology development, a qualitative study was designed to capture and triangulate relevant knowledge and opinions from resource parents, training instructors, and parenting education experts. The most prevalent themes emerging among these stakeholder groups included the need for a simple app interface and the potential for the app to (1) cultivate connection, affirmation, and combat resource parent feelings of isolation; (2) reinforce in-class knowledge and support skill practice at home; and (3) monitor resource parent, child, and family progress over time. Detailed findings are presented, including direct quotes from focus group and interview participants and elaboration on the prevalent themes, which may benefit others in the early stages of human services app design and contribute to the creation of guidelines for the development of technology-based human services interventions.     

Parent training to reduce problem behaviors over the transition to high school: Tests of indirect effects through improved emotion regulation skills

Adolescent problem behaviors are costly for individuals and society. Promoting the self-regulatory functioning of youth may help prevent the development of such behaviors. Parent-training and family intervention programs have been shown to improve child and adolescent self-regulation. This study helps fill gaps in knowledge by testing for indirect effects of the Common Sense Parenting® (CSP) program on reduced substance use, conduct problems, and school suspensions through previously identified short-term improvements in parents' reports of their children's emotion regulation skills. Over two cohorts, 321 low income families of 8th graders were enrolled and randomly assigned to either the standard CSP program, an adapted CSP Plus program, or a minimal-contact control condition. Pretest, posttest, 1-year follow-up, and 2-year follow-up survey assessments were completed by parents and students with 94% retention. Intent-to-treat multivariate path analyses were conducted. Neither intervention had statistically significant total effects on the three targeted adolescent outcomes. CSP, but not CSP Plus, had statistically significant indirect effects on reduced substance use and school suspensions at the 1-year follow-up as well as conduct problems and school suspensions at the 2-year follow-up through increased child emotion regulation skills at posttest. Findings provide some support for emotion regulation as one pathway through which the intervention was associated, indirectly, with reduced substance use, conduct problems, and school suspensions among at-risk students over the high school transition.     

Web-Based Education in the Human Services: Use of Web-Based Video Clips in Counselling Skills Training

SUMMARY

This use of web-based video clips for counsellor skills training is used in the Campus Alberta Applied Psychology Counselling Initiative which provides Master's-level counsellor education at a distance. The core counselling skills course is delivered through the Web using digital video clips of counselling skills demonstrations, chat room skills practice and weekly discussion forums. A follow-up face-to-face Summer Institute allows learners to receive live feedback on their skill development. Course content is grounded in the construct of the working alliance (Bordin, 1979). Course activities use Bloom's taxonomies of learning objectives. Program evaluation suggests that learners are meeting competencies as they move from this course to practicum placements.     

Cultivating knowledge of resiliency and reintegration among military youth through a national youth leadership program

Youth in military families are frequently challenged by the adjustment demands associated with the deployment and reintegration of a parent. A positive youth development approach was undertaken by the Boys and Girls Clubs of America to develop and implement a Military Teen Ambassadors (MTA) training for youth in military families that would facilitate knowledge of resiliency and reintegration and foster leadership skills to build assets for themselves as well as their peers within their local communities. To determine if MTA was functioning as intended and to refine future programming, this preliminary formative study assessed perceived participant learning outcomes associated with MTA on variables pertaining to knowledge acquisition, perceived skill acquisition, and community needs awareness. Data were collected prior to the training, immediately following the training, and 6 months after the training. Repeated measures analysis indicated significant mean increases over time in knowledge and awareness of resiliency and reintegration; perceived leadership skills; and community awareness. Qualitative findings provided triangulation in the aforementioned areas. These findings strengthen the body of knowledge on resiliency by demonstrating that the 7 Cs model may be an effective strategy to incorporate into leadership development programs seeking to build knowledge of resiliency among military youth. Study limitations, lessons learned, and recommendations for further research are delineated.     

Training Student Volunteers for Community Service:

This article discusses the development of a two hour training for undergraduate volunteers in youth programs in community agencies. The trainers, from a Department of Applied Psychology, conceptualized the task in the context of Miller's idea of ''giving psychology away,'' providing psychological knowledge to non-professionals who can benefit from it. The key concept given away in the training is the ''helping alliance,'' an idea from psychotherapy theory, which is modified for the specific context of volunteer helpers. Implementation of the program, preliminary evaluations, and further projects and implications are discussed.     

Project Employ: engineering hope and breaking down barriers to homelessness

The homeless population in the US has dramatically increased in the past two decades. People who are homeless often lack skills sets such as stress management and social skills, independent living skills, and skills for vocational and leisure engagement. Best practice vocational education and training programs for individuals who are homeless recognize that success in the worker role often hinges on a person's capacity to manage day-to-day living. Life skills and pre-employment training are essential components of vocational programs but no more important than interpersonal skill development including anger management, developing self esteem and motivation, building goal setting capacity, and skills for money management, personal budgeting and self-advocacy. These areas of performance have all been traditionally included in occupational therapy's domain of practice. This article describes Project Employ, a grant funded supportive employment program that has grown out of collaboration between Duquesne University's Department of Occupational Therapy and Bethlehem Haven, an emergency shelter and residential recovery program and primary service provider for homeless people in Pittsburgh, Pennsylvania. The purpose of this article is to describe the history, structure and outcomes of Project Employ.