The Future of Parent Training Programs - Essay Example

Topic: What has been learned about the effectiveness, and limitations, of parent training programmes for helping children with externalizing behaviorproblems? What needs to be learned? 1. OVERVIEW OF PARENT TRAINING PROGRAMMES In recent years several parent training programmes have been designed to equip and educate parents on how to proactively handle children suffering from externalizing problems (Nock & Kadzin, 2005). As the number of children exhibiting atypical behaviour or asocial behaviour increases worldwide, one of the parenting programmes that have been used and shown an appreciable level of efficiency lately is the widely implemented Webster-Stratton Model. This Model confronts the issues of externalizing behaviour problems in children by preparing parents to deal with this behavioral problem with ample knowledge gained through three categories of Incredible Years Parent Training Programmes: (i)Babies and toddlers (0-3 years); BASIC Early Childhood (3-6 years) and ADVANCE (4-12 years) (Incredible Years, 2009). The goals of these programmes are to treat children aggressive behavior and ADHD and to build a robust parent-child interaction that would help in raising children that would be socially competent, emotionally strong and enjoy mental alacrity (Incredible Years, 2009). While there have been some improvements in the social behaviors of children in countries where Webster-Stratton Model has been applied, but it had also been discovered that not all of these programmes have been successful or effective: they face some unavoidable limitations due to the process of implementation that worth investigating and proposing better approaches that would be able to withstand both the internalizing and externalizing problems in children. 2. INDICATIONS OF EFFECTIVENESS There are some observable indications that the idea of parent training programmes for helping children with externalizing behaviour problems has been effective: surveys of trial or randomized group control evaluations indicate that there has been improvement in the way parents discipline their children, shunning harsh discipline or spanking that could have made grow into unruly adolescents (Incredible Years, 2009). This action has encouraged children to look up to their parents as problem-solvers, and by engaging them in fruitful communication, instead of resulting to violent outburst. Over the period of the training, the parents’ attitude to interaction with their children has improved, with parents using more positive words or praises to supply the needed encouragement for their children to act well in the society. Webster-Stratton and Hammond (1990) recognized that researchers have previously discovered that the state of parental mental health largely contributes to how their children’s social behaviors are manifested. Those parents who belong to economically disadvantaged group, for instance low- or medium-class families tend to suffer from acute depression as a result of their deplorable living conditions (Webster-Stratton, 1998). Such depressive mood, has been noted, is transferrable to their children, and which would negatively manifest in their behaviors. Therefore, parents training programmes have been able to mentally invigorate the parents so as to appear quite strong before their children; a positive attitude that has been identified as a strengthening force to ameliorating their children’s externalizing behavioral problems. This is position is ably supported by the New Zealand Ministry of Health (Ministry of Health, 2001). Successes of Parent Training Programmes Webster-Stratton Model of Parent Training Programmes has been able to produce recognizable successes in several places of its implementation. The reports published by the New Zealand Ministry of Health (Ministry of Health, 2001) attested to the efficacy of solving externalizing behavior problems in children by actually having their parents set some time apart and be watched by a health specialist in a controlled randomized environment. This circumstance has been able to produce outstanding efficiency in this regard. There are great outcomes from the implementation of Webster-Stratton Model in Sweden, Wales, Ireland, South Korea and, of course, at various centers in the United States—the location of its inception (Webster-Stratton, 1998: Webster-Stratton & Hammond, 1990). However, the rate of efficiency varies from one setting to the other. And this may be a deciding factor into discovering which methodology works the best (Goodman, 1997). Rate of Effectiveness The rate of efficacy of the parent training programmes doesn’t conform to any generalization: that is, while the implementation of Webster-Stratton Model had worked perfectly in a location or country, the result may not be all that satisfactory in the other. There are conditions for this variety in the efficiency of the programmes: (i) the seriousness of the parents in actually learning a new way to handle their children; (ii) the atmosphere of learning or training; (iii) the qualification or experience of the trainers. These are the criteria that could be employed in determining the performance of parent-child randomized group control (Webster-Stratton, 1998). The Scope of Parent Training Programmes What is the specific definition of scope of the parent training programmes? How could its effectiveness be measured? Even though there are impressive results from these programmes, it is still difficult to ascertain the level of its influence in children’s behaviors, generally. Their schoolteachers may observe a change of mannerism: they may appear quieter or more civilized in their relationship with other kids in the class room, but should this be the only yardstick to measure a total change of attitude or a transformative revelation of adapting to a more social lifestyle? (Webster-Stratton & Hammond, 1990). And how much do the parents gain from all these training programmes? It has been discovered that, on most occasions, children do change their habits faster than their parents. This circumstance is not unexpected: an adult often resist any subtle changes in their character or attitude. In this way, it may take a long time for an abusive parent to adopt a new lifestyle than for a child suffering from externalizing behavior problem. So, this issue raises the question about how far parent training programmes could actually help solve this social problem. McNeil et al. (1991) acknowledge the danger of over-dependence on a particular parent training programme because it could lead to over-simplification of this dreaded issue. They wondered how much of the model procedure would amount to a degree of expected efficacy. In other words, they argued stiffly on the scope of parent training programmes in combating the surge in the population of children exhibiting externalizing behavior problems. 3. FEARS OF LIMITATION IN PARENT TRAINING PROGRAMMES From the argument above, it is apparent that certain limitations exist in the parent training programmes. These limiting factors may threaten the correctness or accuracy of the results obtained in the course of implementation. Nixon et al. (2004) elaborate on the necessity of ensuring that all components of implementation, both human or material, must be in good order. Human beings must be in good frame of mind before the commencement of the implementation. In the same way, the instrument or equipment needed for the training must be in good shape. Limitation in Child Behavior Measures Several research findings have revealed the probable inaccuracy that could ensue from measuring Child Behaviour. Even the globally acceptable method of Strengths and Difficulties Questionnaire (SDQ) may not provide the same results at different locations. And it is also possible that the answer provided to the questionnaires may not reflect the true extent of behaviour of the child involved (SDQ; Goodman, 1997). The same reason is applicable to Conner’s Parent and Teacher Rating Scales (Conners, 1997). The impossibility of getting an accurate picture of the children’s behavioral pattern or rate may undermine whatever empirical results that might have been received (Ministry of Health, 2001). Achenbach (1991) believed creating a checklist of what indices to measure in a child’s behavior would help to keep an eye on the most important issues in identifying what has gone wrong in the way the child has been externally misbehaving. Limitation in Measuring Parents’ Functionality Since the main components of the train are parents, it is helpful to determine how functioning they are in the process. If the parents have been wracked by serious stress or depression due to their economic status, it is not uncommon that their attention and functionality during the implementation would be shallow. They would lose concentration on the training programmes, and might end up not different from the same bad conditions that they were (Webster-Stratton, 1998). In order to produce reliable results, Parenting Stress Index (PSI) rate must as well be measured, and its effect on the overall training outcomes should be deducted. However, since it is not possible to correctly estimate the level of the parents’ stress, this index could only be assumed. And anything based on assumption has little or no certainty when it comes to appropriating the exactness of such conditions. Limitations Due to Family Demographics Each child is influenced by the demographics it finds itself: this is why it is impossible to proffer any generalizations when it comes to the prospect of obtaining similar effective results for parent training programmes. The elements of demographics which include the racial/ethnic setting where the child lives, the age of his/her parents, the average education in the family, the financial standing of the family or family income, employment and child developmental materials available around the child. Studying all these materials would provide a helpful data through Family Impact Questionnaire ( FIQ; Donenberg & Baker 1993). In a family, fathers are always on the wrong side of discipline because of their masculine nature: they feel that they have the statutory rights to shout at their children or even kick them in their ribs if they mess up at home and at schools (Mash & Johnston, 1990; Treacy et al., 2005). This doesn’t normally occur in single-parent homes where the only parent thinks lovingly of his/her child and not willing to do anything to harm its feelings. Demographics play an important role in the way children react to the angry things or infuriating actions around them. Since that is the only way to express themselves; they might think it is appropriate to continue in such a way; the result of which would make them asocial or possess externalizing behavior problems. Parent-Child Relationships It has been hypothesized that when the pre-training relationship between parents and their children were not good, it is likely such s relationship won’t improve in the course of the training, most especially when the parents and children are involved in controlled group supervision. This circumstance invokes the certainty of getting incorrect estimation or evaluation of how the children are improving. When parents had subjected their children to harsh punishment that include beating, spanking, aggression, unkind criticism, such attitude would have created a silent hatred in the heart of the children for their parents. Animosity dampens the prospect of getting a perfect result (Webster-Stratton & Hammond, 1990). The basis of any success in parent training programmes would stem from the pre-training conditions. As it is difficult to build a robust relationship overnight, the parents should have demonstrated a gradual change of attitude to their children before the commencement of the training. Another way to investigate if the training could on is to carry out Parent-Child Relationship Index by asking the children some simple questions that could disclose the extent of relationship between the two parties. Domitrovich (2007) believed that giving some measure of encouragement to children may assist them to shed their unsavory lifestyles in order to impress the person encouraging or praising them. This kind of matter is part of good parent-child relationship; which on most occasions is lacking in many homes today, most especially those of poor or middle-class households where parents aree battling acute depression or mental problems arising from low social status or financial incapability. Procedural Limitations Errors in procedures could truncate the expectation of getting a satisfactory outcome in parent training programmes. Many criteria should be seriously taken care of when carrying out these programmes: these include the setting, methodology, reportage and other minor mistakes that could make the programmes short of producing the desired outcomes. This is the area where questions should be asked about the choice of setting, the decision to use a particular model and what are the reactions of the parents and children to these choices. When all these parameters are properly aligned, then it is possible to expect that procedural mistakes would be reduced to barest minimum if not totally eradicated. Because different procedures are employed in various countries with dissimilar modifications, this largely accounts for why there are different outcomes, some performing better than the others. Considering this condition, is it possible to achieve a universal uniformity of implementation? For now, it isn’t realistic, because each child has different psychosocial level; some deteriorated than the others. But the desire to obtain comparative results has been the primary aim of simultaneously carrying out these parents training programmes all over the world. Improper Biases While reporting the findings during the parent training programmes, for instance, when the data collected in the course of the programmes came only from parent-reportage, there is every likelihood that some biases would come up or the real situation of the child’s health (mental or psychological) is not clearly presented due to some reasons that may include the desire to hide the seriousness of the child’s behavioral problem from a third party, doing this out of pride or shame. The use of independent data reporter would have imparted some confidence into the whole process because there would be no reason to imagine any under-dealings had occurred. Verhulst et al. (1997) hinted about the possibility of making useful comparisons with the data collected by the child’s teacher at school. This may create an opportunity to identify the true picture of the child’s externalizing behavior. Teachers are known to be critical in handling such data, as they know the implication of being floppy with such sensitive pieces of information: a situation that may lead to their expulsion from the school or even facing a lawsuit. This matter is so important that if it is carelessly dealt with, it would undermine the veracity of the overall parent training operations. Robison et al (1980) also shared the same view as Verhulst et al., by indicating that making a list of externalizing behavioral problems that the training should target would help avoid concentrating on the area of the child’s life that has currently been undergoing self-development. For example, a child who still fights everyone on the street may have stopped biting his/her victims. Therefore, improper biases on the part of parents could force the school authorities to step in and save the children (Wilson & Lipsey, 2007; Henry et al. 2000; Arnold et al. 1998; Barera et al, 2002). Parent Training Programmes Models Even though Webster-Stratton Model seems to be the most popular parent training programmes model currently in the world, however, its stories of success in one country should be used as a yardstick to predict relative success in other countries. It has been revealed that when the afore-mentioned model is to be carried out in another country, certain conditions have to be altered in order to obtain a satisfactory result. This condition if universal inapplicability puts the model at risk of being heavily criticized if it fails in another location apart from the United States where it was developed. This issue then constitutes a great challenge for all the agencies and individual practitioners who have implemented the model to revive the mental and psychological health of their clients and their children. This limitation stands out among the others in the sense that it threatens the general acceptability of this unique model and the others experiencing this kind of problem. Drugli & Larsson (In press) jointly criticized any attempt to generalize the applicability of any specific parent training model: their observation came from analyzing the different outcomes obtainable from different scenarios or circumstances, even though the same model is employed. 4. MORE EXPECTATIONS ABOUT PARENT TRAINING PROGRAMMES There are a lot of useful ideas that seem to be hidden about parent training programmes: these are the areas experts in child psychology, clinicians and psychiatrists are mostly interested in knowing in order to offer better services to the clients and their children. These significant factors are highlighted below, not necessarily in their order of importance. Localization of model procedure It is no more news that when different countries are implementing a popular or widely applied parent training programme model, there are certain modification they make on the original methodology in order to achieve an optimal result in their exercise (Webster-Stratton, 1998). But the question is what criteria should be modified, and by what degree of variety? If more criteria are removed from an implementation of a particular parent training programmes its outcome, at that location, maybe subjected to doubt and inaccuracy. Such results may be discarded or rendered useful; and it could not be utilized as a base of comparison with that from another country. For example, if trainers in one country decide to forgo Family Impact Questionnaire (FIQ) because the parents of the child object to it on the ground of secrecy of private information, the overall result of the training may be inconclusive as the extent of family influence on the child hasn’t been quantified. Psychosocial Analysis of the Parents How much of the parents’ conditions should be known? Is it helpful if the previous lifestyle of the parents is analyzed? Was one of the parents a criminal, and how would that affect the character or externalizing behavior of the child? Doing more psychosocial analysis on the parents would help understand where the children have inherited their strange and atypical behaviors (Wilson & Lipsey, 2007). It is naturally believed that children would pick one or two attributes of their parents as they grow up. This is wrapped in either religious or traditional belief that a father who was a thief would definitely give birth to a child that also steal! The same reason goes for children of high-educated academics who begin to behave like an academician right from a tender age. But how would such quality in parents be measured? And is there a scale on which one could gauge the functionality of parents on when it comes to parent training programmes? Ideal Setting and Methodology For example, when Webster-Stratton Model is being implemented at a particular location, it is important that certain constituents of the setting be altered in order to be able to carry it out successfully. Even though the setting would be controlled, it still has some different components from the original Model that was executed in the United States. The same reason is applicable to changing the methodology to fit a particular setting. What could be changed in methodology may include the time for collecting the data or alternating the parties involved in the implementation, perhaps the psychologist or the clinician. This would add more variety into the processes . These assumptions followed are supported by Webster-Stratton and Hammond (1990) in their personal opinions about making parent training affordable for all classes in the society. Comparative Reportage The essence of comparative reportage is to prevent an occasion whereby parents shy away from revealing the real condition of their children. Apart from including the schoolteachers’ data in the overall outcomes, other independent reports on the behavior of the child may be admitted and compared with the rest in order to highlight the true condition of the child behaving abnormally. Comparative reportage would make the results reliable and impartial: and it would help to find the direct way to address the main cause of externalizing behavior problems in the children (Verhulst et al. 1997; Arnold et al. 1998). Cost of Execution It is helpful to talk about the cost of executing this parent training programmes. It is too costly, it will scare some middle-class parents away, and they would never have an opportunity to solve the major problem bothering their family. The cost should be reasonable, while the service should be superb to keep attracting both the parents and their children (Webster-Stratton & Hammond, 1990). 5. CONCLUSION The issue of parent training programmes is gaining ground now as the number of children demonstrating externalizing behavior problems is increasing. This may have been as a result of escalating poverty and loss of employment in average households. Children are coping with the stress on their parents due to the factors mentioned earlier. However, some children fall behind in coping with the ugly situations and they begin to act strangely: they started to exhibit some forms of externalizing behavioral problems by being violent or overtly aggressive. Until now, some parents still struggle with how to handle this serious issue. But the availability of child-parent training programmes expounded by Webster-Stratton and her colleagues has been able to help many parents and families surmount this major problem (Incredible Years, 2009). While this methodology has proved successful in various applications, there are still some limitations in its widespread implementation: clinicians, trainers, health professionals and psychologists/psychiatrists have to contend with some factors that seemed to frustrate their attempts at helping troubled children. These factors include improper implementation, poor domestication of the model, unfavorable parent-child relationship, economic status and societal influences (Webster-Stratton & Hammond, 1990). What is the future of parent training programmes like? Will these solutions stay competitive and efficient for some years to come? And how many children with externalizing behavioral problems would be transformed through these process? And what could the political class do to encourage maximum participation of parents in attending to the needs of their troubled children? These important expectations are still in limbo: every caring parent having a child with atypical waits to see the day parent training programmes would receive maximum support in the society! References 1. Conners, C.K. (1997). Conners’ Rating Scales — Revised technical manual. New York: Multi-Health 2. Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry, 32, 581–586. 3. Webster-Stratton, C. (1998). Parent training with low-income families; Promoting parental engagement through a collaborative approach. In J.R. Lutzker (Ed.), Handbook of child abuseresearch and treatment (pp. 183–210). New York: Plenum 4. Donenberg G. & Baker B. L. (1993) The impact of young children with externalizing behaviors on their families. Journal of Abnormal Child Psychology 21, 179–98. 5. Webster-Stratton C. & Hammond M. (1990) Predictors of treatment outcome in parent training for families with conduct problem children. Behavior Therapy 21, 319–37. 6. Mash, E., & Johnston, C. (1990). Determinants of parenting stress: Illustrations from families of hyperactive children and families of physically abused children. Journal of Clinical Child Psychology, 19, 313–328. Ministry of Health. (2001). 7. Treacy, L., Tripp, G., & Barid, A. (2005). Parent stress management training for attention deficit hyperactivity disorder (ADHD). Behavior Therapy, 36, 223–233. 8. Nock, M.K., & Kazdin, A.E. (2005). Randomized controlled trial of a brief intervention for increasing participation in parent management training. Journal of Consulting and Clinical Psychology, 77, 872–879. 9. Ministry of Health. (2001). New Zealand guidelines for the assessment and treatment of attentiondeficit/ hyperactivity disorder. Wellington: New Zealand: Ministry of Health. 10. Achenbach TM (1991) Manual for the Child Behavior Checklist 4-18 and 1991 profile. Burlington: University of Vermont, Department of Psychiatry 11. Drugli MB & Larsson B (In press) Children aged 3-8 years treated with parent training and child therapy because of conduct problems: generalisation effects to day-care and school settings. European Child and Adolescent Psychiatry. 12. McNeil CB, Eyberg S, Eisenstadt TH, Newcomb K, Funderburk B (1991) Parent-child interaction therapy with behavior problem children: Generalization of treatment effects to the school setting. Journal of Clinical Child Psychology, 20 (2): 140- 151 13. Nixon RD, Sweeney L, Erickson DB, Touyz SW (2004) Parent-child interaction therapy: One-and two-year follow-up of standard and abbreviated treatments for oppositional preschoolers. Journal of Abnormal Child Psychology, 32 (3): 263-271 14. Verhulst FC, Dekker MC, Van der Ende J (1997) Parent, teacher and self reports as predictors of signs of disturbance in adolescents: whose information carries the most weight? Acta Psychiatrica Scandinavica, 96: 75-81 15. Robinson EA, Eyberg SM, Ross AW (1980) The standardization of an inventory of child conduct problem behaviours. Journal of Clinical Child Psychology, 19: 1344- 1349 16. Domitrovich, C., Cortes, R. & Greenberg, M. (2007) Improving young children’s social and emotional competence: a randomized trial of the preschool PATHS curriculum. The Journal of Primary Prevention, 28, 67–91. 17. Wilson, S. & Lipsey, M. (2007) School based interventions for aggressive and disruptive behavior. Update of a meta-analysis. American Journal of Preventative Medicine, 33, S130–143. 18. Henry, D., Guerra, N., Huesmann, R., Tolan, P., VanAcker, R. & Eron, L. (2000) Normative influences on aggression in urban elementary school classrooms. American Journal of Community Psychology, 28, 59–81. 19. Arnold, D., Williams, L. & Arnold, E. (1998) Teacher discipline and child misbehavior in day care: untangling causality with correlational data. Developmental Psychology, 34, 276–287. 20. Barrera, M., Biglan, A., Taylor, T., Gun, B., Smolkowski, K., Black, C., Ary, D. & Fowler, R. (2002) Early elementary school intervention to reduce conduct problems: a randomized trial with Hispanic and non-Hispanic children. Prevention Science, 3, 83–94. 21. Incredible Years (2009). Evidence of Effectiveness. Retrieved on May 25, 2009 http://www.incredibleyears.com/ResearchEval/effective.asp Read More