In the 1920s researchers concluded that the child’s environment and parenting practices play an integral role in the development of antisocial behavior in children (Shaffer, Kotchick, Dorsey & Forehand, 2001). Parents therefore should be the primary target for interventions with anti social youth. It was only in the 1960s that traditional psycho dynamic approaches to treating such behaviors were seen as not very effective and there as a shift to behavior modification as therapists started training parents in techniques to modify their children’s behavior. Shaffer, Kotchick, Dorsey and Forehand (2001) go on to explain that the therapist presented the parent with parenting techniques based on structured behavioral modeling, role plays and practice sessions and home work assignments for parents to practice at home. Early studies found positive results for this parent training in a reduction in negative behaviors in the child and improvements in the parenting. These effects were generalized to other settings such as the school and to the siblings. Researchers also considered the factors affecting the parent training such as socioeconomic factors and marital adjustment and applied these to expand the curriculum for parent training ( Shaffer, Kotchick, Dorsey & Forehand, 2001).
The Behavior Parent Training program involved three major things- teaching the parent more adaptive response to a child’s non compliant behavior, i.e. breaking the coercive cycle that is set up when the child is exhibiting non compliant behavior; helping the parent to pay attention to positive rather than negative behavior and increasing the use of positive reinforcement strategies; intervening early to avoid patterns of negative behavior developing.

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Examples of externalizing behavior problems in children, for which they are referred for mental health services, include inattention, over activity, impulsivity, non compliance and aggression (Mah and Johnston, 2008). These externalizing behaviors problems usually affect multiple areas of life and can put child at risk for later negative outcomes such as alcoholism, drug abuse, poor employment history, poor marital functioning (Mah and Johnston, 2008) thus interventionists looked for parenting practices to help reduce these problems. According to Mah and Johnston (2008) “behavioral parent training (BPT) is one of the most effective ways to change parenting behavior and is an evidence-based treatment for externalizing child behavior problems” (p. 219). They go on to explain that BPT programs apply social learning principles to help parents to be change agents in children’s lives.

The many BPT programs that exist have common characteristics. The parents observe and monitor the child’s behavior. They give concise and clear commands. They positively reinforce appropriate behavior with rewards or praise and extinguish or punish inappropriate behavior with differential attention or time outs. Some of the positive effects of BPT as reported by these authors include “improvements in parent-child communication, parenting self -esteem, maternal depression, parenting stress, and behavior of siblings” (p.219). Follow up data indicate small but continued effects of behavior programs. Some researchers have suggested that the effect size for BPT programs is small- moderate, the long term effect is limited and not all families benefit equally. Some of the factors identified for negatively affecting the outcomes are family demographics, e.g. socioeconomic status, large family size, single parent stress, lower educational level of parents, younger maternal age, minority status, child characteristics or child behavior problems (Mah and Johnston, 2008). However the authors point out that these factors cannot always be changed and therefore they suggest that other factors, such as parent’ social- cognitive aspects, could contribute to positive effects of BPT programs. They posit that including how the parents apply cognitive processes (thoughts and emotions) to their behavior can improve how they accept and engage in the BPT programs through improved parenting efficacy. Mah and Johnston’s study of an enhanced BPT program that addressed the parents’ social cognitions found that there was more motivation and higher attendance at the sessions and the parents showed greater adherence to the treatment strategies.

Despite the positive results with BPT programs among general families reported in some studies, other researchers report poor adherence to BPT strategies, poor attendance and late arrivals to sessions, and participants discontinuing treatment prematurely (Fabiano, 2007). Strategies were therefore sought to increase engagement and to identify specific groups who may have barriers to participating in such programs. One such group is fathers; in particular Fabiano studied fathers with children with ADHD, as BPT has been used as treatment for ADHD for forty years. This group of parents is important to look at since parental functioning is greatly affected by having a child in the home with ADHD; parents are more stressed, parent-child interactions are imparted, there is a strain on the family relationships. Therefore BPT is thought to be beneficial in such circumstances. In the review of the literature Fabiano found little data on the effectiveness of BPT programs for fathers and no direct studies on fathers involved in BPT for child a child with ADHD. Since fathers contribute to many aspects of the child’s development, including the relationship with the mother, increased father involvement and use of parenting strategies can lead to fewer behavior problems (Fabiano, 2007).

During adolescences there is a higher level of oppositional and defiant behavior and parents report high levels of parenting-related stress (Griffith, 2010). Positive parenting practices such as monitoring, rule-setting, and reinforcement for positive behavior were associated with lower levels of negative adolescent behavior. Interventions other than family therapy that influence parent behavior may therefore be effective to help adolescents with problem behavior and so parent training programs are seen as a common intervention (Griffith, 2010). The Common Sense Parenting program has been reported to be an effective behavior parent training program for 6-16 yr old. Although this and other BPT programs have been shown to produce positive results in changing antisocial and other negative behaviors in children and youth, further research is needed to examine the effects of these programs in a wide range of family situations.

    References
  • Fabiano, G. A. (2007). Father participation in Behavioral Parent Training for ADHD: Review and recommendations for increasing inclusion and engagement. Journal of Family Psychology, 21 (4), 683-693.
  • Griffith, A. K. (2010). The use of Behavioral Parent Training programs for parents of adolescents. Journal of At-Risk Issues, 15 (2), 1-8.
  • Mah, J.& Johnston, C. (2008). Parental social cognitions: Considerations in the acceptability of and engagement in Behavioral Parent Training. Clinical Child and Family Psychology Review, 11 (4), 218-236
  • Shaffer, A. Kotchick, B.A., Dorsey, S. &Forehand, R. (2001). The past, present, and future of Behavioral Parent Training: Interventions for child and adolescent problem behavior. The Behavior Analyst Today, 2 (2), 91-105