Toward Improved Parenting Interventions for Disruptive Child Behavior : Engaging Disadvantaged Families and Searching for Effective Elements

Abstract

Parenting interventions are a promising strategy to prevent antisocial behavior in society. Evidence accumulates that parenting interventions can reduce disruptive child behavior, and insight rapidly increases into which families they benefit most. At the same time, however, several high risk populations are hardly reached by current interventions, effect sizes of parenting interventions remain small to moderate, and about a quarter to a third of families fail to show improvement from parenting interventions. Accordingly, important challenges lie ahead for research and society to use parenting interventions in their most optimal form. This dissertation aimed to meet two key challenges for evidence-based parenting intervention in particular: (1) to increase our understanding of how parenting interventions can reach and benefit disadvantaged families, and (2) to optimize the effectiveness of established parenting intervention programs. In Part 1, we examined the extent to which families with low socioeconomic status and/or ethnic minority backgrounds can be reached by and benefit from parenting interventions. We found that overall, families of children with severe behavior problems from different socioeconomic backgrounds can benefit equally from parenting interventions, but that families with lower socioeconomic status may experience more trouble maintaining positive change. Using the Incredible Years parent training program, we showed that families with different ethnic backgrounds can show equal improvements in parenting and child behavior after receiving an empirically supported parenting intervention. This finding supports the implementation of parenting interventions such as Incredible Years for families with different cultural backgrounds. However, our findings (and those of others) consistently indicate the importance of proactively overcoming families’ barriers to treatment to successfully engage families in parenting interventions. We showed that working collaboratively with schools and lowering thresholds for participation (e.g., no formal diagnostic procedures) helps to overcome some key barriers and can lead to increased participation of socioeconomically disadvantaged and ethnic minority families in parenting interventions. In Part 2, we stated that increased insight into which discrete parenting intervention elements contribute to program effectiveness is an important step toward more effective parenting interventions. We provided a framework on how research on the evaluation of parenting intervention program packages can be complemented with research on the evaluation of discrete parenting intervention elements. In two field experiments, we studied a discrete parenting intervention element on its empirical merit: The widely used, but understudied, parenting advice to use labeled rather than unlabeled praise to improve child behavior. Our experiments supported to use of praise to improve child behavior. However, they did not support the superiority of labeled over unlabeled praise. Labeled and unlabeled praise were equally effective in reducing disruptive child behavior, and labeled praise was even less effective than unlabeled praise for families who intuitively used relatively much unlabeled praise. We conclude that parenting interventions are an effective strategy to enhance child development in families from different socioeconomical and ethnic backgrounds. More research is needed on how the effectiveness of established parenting interventions can be improved, to increase their impact and benefit the lives of families and society at large.