Parent Education Programs as a Psychiatric Approach to Children with Conduct Disorder: An Evaluation through Two Samples

Yıl 2009, Cilt: 1 Sayı: 2, 155 - 174, 01.06.2009

Burcu Arkan Besti Üstün

Öz

Conduct disorder is a category to describe the behaviors which have an adverse affect on the individual, family or society, violate the basic rights of other people and ignore the age-appropriate social norms and rules. Parental behaviors should be shaped as well as those of the children in order for conduct disorder to be treated. The reason for this is that parental attitudes play a key role in emergence of anti-social behaviors among children. Therefore, parent programs have been undertaken for the last thirty years. It has been proved that parent programs are effective in children with conduct disorder who display highly disruptive behaviors. The two best parent programs implemented on the parents of children diagnosed with conduct disorder are Triple P and Incredible Years which cooperate with families and the society, reduce the risk factors, support the protective factors, have a multi-disciplinary approach (psychiatrist, psychologist, nurse, child development and educationalist, social service specialist, psychological consultant, teacher, etc.), having high evidence standards, use randomized controlled studies and yield long-term results. For that reason, this literature review was conducted in order to evaluate the efficacy of these two programs, to determine the differences, what is known about the issue.

Anahtar Kelimeler

Conduct Disorder, Parent Program, Triple P, Incredible Years

Davranım Bozukluğu Olan Çocuklara Psikiyatrik Yaklaşımda Anne-Baba Eğitim Programları: İki Örnek Bağlamında Bir Değerlendirme

Öz

Davranım bozukluğu bireyi, aileyi ve toplumu olumsuz yönde etkileyen, diğer insanların temel haklarının çiğnendiği, yaşa uygun toplumsal norm ve kuralların hiçe sayıldığı davranışlardan oluşan bir bozukluktur. Davranım bozukluğunun tedavisinde, çocuklarıyla birlikte anne-babaların davranışlarının şekillendirilmesi gerekmektedir. Çünkü anne-babaların tutumları, çocuğun antisosyal davranışlarının gelişmesinde temel rol oynamaktadır. Bu nedenle anne-baba eğitimi programları son 30 yıldan bu yana sürdürülmektedir. Anne-baba eğitimi programlarının, davranım bozukluğu olan ve yüksek düzeyde yıkıcı davranışlar sergileyen çocuklarda etkili olduklarına ilişkin kanıtlar elde edilmiştir. Davranım bozukluğunun tedavisinde kullanılan Üç P (Triple P) ve İnanılmaz Yıllar (Incredible Years) Anne-baba Eğitimi Programları; aile ve toplumla işbirliği yapan, risk faktörlerini azaltan, koruyucu faktörleri destekleyen, multidisipliner (psikiyatrist, psikolog, hemşire, çocuk gelişim uzmanı, sosyal hizmet uzmanı, psikolojik danışman, öğretmen… vb.) yaklaşıma sahip, kanıt standartları yüksek, randomize kontrollü çalışmaların kullanıldığı ve uzun süreli sonuçların elde edildiği en iyi iki anne-baba eğitimi programdır. Bu çalışmada Üç P ve İnanılmaz Yıllar programlarını değerlendirmek ve bu iki program ile ilgili bilinenleri açıklamak, farklılıkları ortaya koymak amaçlanmıştır.

Anahtar Kelimeler

Davranım bozukluğu, anne-baba eğitimi programı, Üç P, İnanılmaz Yıllar

Kaynakça

• Krol N., Morton J., De-Bruyn E. Theories of conduct disorder: a causal modelling analysis. J Child Psychol Psychiatry 2004; 45: 727–742.
• Moffitt TE, Arseneault L, Jaffee SR, Kim-Cohen J, Koenen KC, Odgers CL et al. Research Review: DSM-V Conduct Disorder: Research Needs For An Evidence Based. J Child Psychol Psychiatry 2008; 49:3–33.
• Webster-Stratton C., Hammond M. Conduct problems and level of social competence in head start children: Prevalence, pervasiveness, and associated risk factors. Clin Child Fam Psychol Rev 1998; 1:101–123.
• Frick P. Developmental pathways to conduct disorder: Implications for serving youth who show severe aggressive and antisocial behavior. Psychol Sch 2004; 41: 823–831.
• Nicholson JM, Phillips M, Whitton S, Halford WK, Sanders MR. Promoting healthy stepfamilies: Reasons for seeking help and perceived benefits from intervention. Fam Matters, 2008; 77: 48-56.
• Mihalopoulos C, Sanders MR, Turner KMT., Murphy-Brennan M, Carter R. Does The Triple P - Positive Parenting Program provide value for money? Aust N Z J Psychiatry 2007; 41: 239-246.
• Sanders MR, Woolley ML. The relationship between maternal self-efficacy and parenting practices: implications for parent training. Child Care Health Dev 2005; 31: 65-73.
• Sanders MR, Markie-Dadds C, Rinaldis M, Firman D, Baig N. Using household survey data to inform policy decisions regarding the delivery of evidence- based parenting interventions. Child Care Health Dev 2007; 33: 768-783.
• Webster-Stratton C. Comparison of abusive and nonabusive families with conduct-disordered children. Am J Orthopsychiatry 1985; 55: 59–69.
• Webster-Stratton C, Reid JM, Hammond M. Preventing conduct problems, promoting social competence: A parent and teacher training partnership in head start. J Clin Child Adolesc Psychol 2001; 30:283–302.
• Webster-Stratton C, Hammond M. Marital conflict management skills, parenting style, and early-onset conduct problems: Processes and pathways. J Clin Child Psychol 1999; 40: 917–927.
• Mcfarland ML, Sanders MR. The effects of mothers' depression on the behavioral assessment of disruptive child behavior. Child Fam Behav Ther 2003; 25: 39-63.
• Morawska A, Sanders MR. Concurrent predictors of dysfunctional parenting and parental confidence: implications for parenting interventions. Child Care Health Dev 2007; 33: 757–767.
• Sanders MR, Markie-Dadds C, Rinaldis M, Firman D, Baig N. Using household survey data to inform policy decisions regarding the delivery of evidence- based parenting interventions. Child Care Health Dev 2007; 33: 768-783.
• Ralph A, Toumbourou JW, Grigg M, Mulcahy R, Carr-Gregg M, Sanders MR. Early intervention to help parents manage behavioural and emotional problems in early adolescents: what parents want. Australian e-Journal for the Advancement of Mental Health 2003; 2: 1-12.
• Bor W, Sanders MR. Correlates of self-reported coercive parenting of preschool-aged children at high risk for the development of conduct problems. Aust N Z J Psychiatry 2004; 38: 738-745.
• Sanders MR, Ralph A, Thompson R, Sofronoff K, Gardiner P, Bidwell K, et al. Every Family: A Public Health Approach To Promoting Children’s Wellbeing. Brief Report. The University of Queensland: Brisbane, Australia. 2005; www.pfsc.uq.edu.au, Erișim Tarihi: 12. 01. 2008.
• Ronald JP, Jean ED. Prevention of Oppositional Defiant Disorder and Conduct disorder in Children and Adolescents. In Paula M. B., Thomas H. O, eds Handbook of Interventions that Work with Children and Adolescents: Prevention and Treatment. John Wiley & Sons Ltd. 2007; 475–488.
• Herbert M. Conduct Disorders and Delinquency. In Developmental Problems of Childhood and Adolescence, John Wiley & Sons Ltd. 2008; 215-226.
• National Of Institute For Health And Clinical Excellence. Parent- Training/Education Programmes in The Management Of Children With Conduct Disorders. NICE Technology Appraisal Guidance. 2007. Erișim Tarihi: www.nice.org.uk.
• Clark SB, Rapkin K, Busen HN, Vasquez E. Nurse practitioners and parent education: a partnership for health. Clin Res 2001; 13: 310–316.
• Petersson K, Petersson C, Kansson A. What is good parenteral education? Scand J Caring Sci 2004; 18: 82–89.
• Sanders MR, Turner KMT, Markie-Dadds C. The development and dissemination of the triple p-positive parenting program: a multilevel, evidence-based system of parenting and family support. Prevention Science 2002; 3:173–189.
• Sanders MR, Markie-Dadds C, Turner KMT. Theoretical, scientific and clinical foundations of the triple p - positive parenting program: a population approach to the promotion of parenting competence. Parenting Research and Practice Monograph 2003; 1: 1-21.
• Turner KMT, Sanders MR. Dissemination of evidence-based parenting and family support strategies: learning from the triple p-positive parenting prog- ram system approach. Aggress Violent Behav 2006; 11: 176–193.
• Morawska A, Sanders MR. A review of parental engagement in parenting interventions and strategies to promote it. Journal of Children’s Services, 2006; 1: 29-40.
• Pinsker M, Geoffroy K. A comprasion of parent effectiveness training and bahavior modification parent training. Fam Relat 1981; 1:61–68.
• Dembo HM, Sweitzer M, Lauritzen P. An evaluation of group parent education: behavirol, pet, and adlerian programs. Rev Educ Res 1985; 55:155–200.
• Money S. Parent training: A review of adlerian, parent effectiveness training and behavirol research. The Family Journal 1995; 3: 218–230.
• Gross D, Grady J. Group-Based parent training for preventing mental health disorders ın children. Ment Health Nurs 2002; 23:367–383.
• Goddard WH, Myers-Walls AJ, Lee TR. Parenting: have we arrived? or do we continue the journey? Fam Consum Sci Res J 2004; 33: 57–474.
• Knapp AP, Deluty HR. Relative effectiveness of two behavioral parent training programs. J Clin Child Psychol 1989; 18:314–322.
• Day C, Davis H. Community child mental-health services: A framework for the development of parenting ınitiatives. J Clin Child Psychol Psychiatry 1999; 4:475–482.
• Bayraktar F. Olumlu ergen gelișiminde ebeveyn/akran ilișkilerinin önemi. Çocuk ve Gençlik Ruh Sağlığı Dergisi 2007; 14:157–165.
• Assemany EA. Negative treatment outcomes of behavioral parent training programs. Psychol Sch 2002; 39:209–217.
• Child and Youth Mental Health Plan For British Columbia. February 2003. http://www.mcf.gov.bc.ca/mental_health/mh_publications/cymh_plan.htm Erișim Tarihi: 26.02.2009
• Mullett J, Triple P. Community Implementation Report. Victoria, BC: Action Research Consulting. Report Prepared For The Vancouver Island Health Authority. 2007
• Sanders MR, Turner KMT. Reflections on the challenges of effective dissemination of behavioural family ıntervention: our experience with the Triple P - positive parenting program. Child Adolesc Psychiatry Ment Health 2005; 10:158-169.
• Sanders MR, Calam R, Durand M, Liversidge T, Carmont SA. Does self-directed and web-based support for parents enhance the effects of viewing a reality television series based on the triple-p positive parenting programme? J Child Psychol Psychiatry 2008; 49:924-932.
• Sanders MR, Murphy-Brennan M, Mcauliffe C. the development, evaluation and dissemination of a training program for general practitioners in evidence- based parent consultation skills. Int J Ment Health Prom 2003; 5:13-20.
• Sanders MR. The translation of an evidence-based parenting program into regular clinic services. Australian E-Journal for the Advancement of Mental Health, 2003; 2 (3): www.auseinet.com/journal/vol2iss3/sanderseditorial.pdf.
• Morawska A, Stallman HM, Sanders MR, Ralph A. Self-directed behavioral family intervention: do therapists matter? Child Fam Behav Ther 2005; 27:51- 72.
• Seng AC, Prinz RJ, Sanders MR. The role of training variables in effective dissemination of evidence-based parenting ınterventions. International Journal of Mental Health Promotion 2006; 8:19-27.
• Sanders MR, Prinz R. Ethical and professional issues in the implementations of population-level parenting interventions. Public Health Approaches to Parenting 2008; 15:130–136.
• Markie-Dadds C, Sanders MR. A controlled evaluation of an enhanced self- directed behavioural family ıntervention for parents of children with conduct problems ın rural and remote areas. Behav Change 2006; 23: 55-72.
• Nowak C, Heinrichs N. A comprehensive meta-analysis of triple p-positive parenting program using hierarchical linear modeling: effectiveness and moderating variables. Clin Child Fam Psychol Rev 2008; 11:114-144.
• Prinz RJ, Sanders MR. Adopting a population-level approach to parenting and family support. Clin Psychol Rev 2007; 27:739-749.
• Graaf I, Speetjens P, Smit F, Wolff M, Tavecchio L. Effectiveness of the triple p positive parenting program on behavioural problems in children: Meta- analysis. Behav Modif 2008; 32:714–735.
• Connell S, Sanders MR, Markie-Dadds C. Self-Directed behavioral family intervention for parents of oppositional children ın rural and remote areas. Behav Modif 1997; 21:379-408.
• Nicholson JM, Sanders MR. Randomized controlled trial of behavioral family ıntervention for the treatment of child behavior problems ın stepfamilies. J Divorce & Remarriage 1999; 30:1–23.
• Stallman HM, Ralph A. Reducing risk factors for adolescent behavioural and emotional problems: a pilot randomised controlled trial of a self-administered parenting ıntervention. Australian e-Journal For The Advancement of Mental Health 2007; 6(2):1-13.
• Leung C, Sanders MR, Leung S, Mak R, Lau J. An outcome evaluation of the implementation of the triple p- positive parenting program ın hong kong. Fam Process 2003; 42: 531-544
• Halford K, Nicholson J, Sanders MR. Couple communication in stepfamilies. Fam Process 2007; 46:471-483.
• Matsumoto Y, Sofronoff K, Sanders MR. The efficacy and acceptability of the triple p parenting program ın a cross-cultural context: Results of an efficacy trial. Behav Change 2007; 24:205-218.
• Mcfarland ML, Sanders MR. The effects of mothers' depression on the behavioral assessment of disruptive child behavior. Child Fam Behav Ther 2003; 25:39-63.
• Calam R, Sanders MR, Miller C, Carmot SA. Can technology and the media help reduce dysfunctional parenting and increase engagement with preventative parenting interventions? Child Maltreat 2008; 13:347–361.
• Turner KMT, Sanders MR. Help when it’s needed first: a controlled evaluation of brief, preventive behavioral family intervention in a primary care setting. Behav Ther 2006; 37:131–142.
• Markie-Dadds C, Sanders MR. Self-Directed Triple P (Positive Parenting Pro- gram) for mothers with children at-risk of developing conduct problems. Be- hav Cogn Psychother 2006; 34:259–275.
• Morawska A, Sanders MR. Self-administered behavioral family intervention for parents of toddlers: effectiveness and dissemination. Behav Res Ther 2006; 34:259–275.
• Martin AJ, Sanders MR. Balancing work and family: a controlled evaluation of the triple p- positive parenting program as a work-site intervention. Child Adolesc Psychiatry Ment Health 2003; 8:161–169.
• Turner KMT, Sanders MR. Family intervention in indigenous communities: emergent issues in conducting outcome research. Australas Psychiatry, 2007; 15:39-43.
• Turner KMT, Richards M, Sanders MR. Randomised clinical trial of a group parent education programme for australian indigenous families. J Paediatr Child Health 2007; 43:429–437.
• Hutchings J, Bywater T, Daley D, Lane E. A pilot study of the webster-stratton incredible years therapeutic dinosaur school programme. Clinical Psychology Forum 2007; 170:21–24.
• Webster-Stratton C, Reid JM. A School-Family Partnership: Addressing Mul- tiple Risk Factors To Improve School Readiness and Prevent Conduct Prob- lems in Young Children. Treatment Description, University of Washington. 2008.
• Webster-Stratton C. From parent training to community building. Fam Soc, 1997; 78:156–171.
• Reid MJ, Webster-Stratton C, Hammond M. Follow-up of children who re- ceived the incredible years intervention for oppositional-defiant disorder: Maintenance and prediction of 2-year outcome. Behav Ther 2003; 34:471–491.
• Webster-Stratton C, Reid JM. Working With Families Who Are Involved In The Child Welfare System. Treatment Description, University of Washington. 2005
• Jones K, Daley D, Hutchings J, Bywater T, Catrin Eames C. Efficacy of the in- credible years basic parent training programme as an early intervention for children with conduct problems and ADHD. Child Care Health Dev 2007; 1:1-7.
• Lees D, Ronan K. Engagement and effectiveness of parent management train- ing (incredible years) for solo high-risk mothers: A multiple baseline evalua- tion. Behav Change 2008; 25:109–128.
• Letarte M., Normandie S. Parent Training Program With ADHD: Who Benefits? Presented at Biennial meeting of the International Society for the Study of Behavioural Development, Wurzburg, 2008.
• Webster-Stratton C. Videotape modeling: A method of parent education. J Clin Child Psychol 1981; 10:93–98.
• Webster-Stratton C. Early Intervention with Videotape Modeling: Programs For Families of Children With Oppositional Defiant Disorder Or Conduct Dis- order. University of Washington. Chapter In M. J. Guralnick (Ed.) The Effective- ness of Early Intervention: Second Generation Research. 1996; 429–454. Balti- more, MD. Paul Brookes.
• Spitzer A, Webster-Stratton C, Hollinsworth T. Coping with conduct-problem children: parents gaining knowledge and control. J Clin Child Psychol 1991; 20: 413–427.
• Webster-Stratton C. Annotation: Strategies for working with families of con- duct-disordered children. J Child Psychol Psychiatry 1991; 32:1047–1062.
• Webster-Stratton C. Quality Training, Supervision, Ongoing Monitoring, And Agency Support: Key Ingredients To Implementing The Incredible Years Pro- grams With Fidelity. Treatment Description, University of Washington, 2004.
• Patterson J, Barlow J, Mockford C, Klimes I, Pyper C, Stewart-Brown S. Improv- ing mental health through parenting programmes: block randomised con- trolled trial. Arch Dis Child 2002; 87:472–477.
• Kim E, Cain K, Webster-Stratton C. The preliminary effect of a parenting prog- ram for Korean American mothers: A randomized controlled experimental study. Int J Nurs Stud 2008; 45: 1261-1273.
• Webster-Stratton C. Advancing videotape parent training: a comparison study. J Consult Clin Psychol 1994; 62:583–593.
• Drugli MB, Larsson B. Children aged 4–8 years treated with parent training and child therapy because of conduct problems: generalisation effects to day-care and school settings. Child Adolesc Psychiatry Ment Health 2006; 15:392-399.
• Gross D, Fogg L, Webster-Stratton C, Garvey C, Julion W, Grady JÂ. Parent training of toddlers in day care in low-income urban communities. J Consult Clin Psychol 2003; 71:261–278.
• Hutchings J, Bywater T, Daley D. A pragmatic randomised controlled trial of a parenting intervention in sure start services for pre-school children at risk of developing conduct disorder: how and why did it work? Journal of Children’s Services 2007; 2:4–14.
• Larsson B, Fossum S, Clifford G, Drugli MB, Handegård BH, Mİrch WT. Treatment of oppositional defiant and conduct problems in young Norwegian children: results of a randomized controlled trial. Eur Child Adolesc Psychiatry 2008; 18:42-52.
• Taylor TK, Schmidt F, Pepler D, Hodgins H. A comparison of eclectic treatment with webster-stratton's parents and children series in a children's mental health center: a randomized controlled trial. Behav Ther 1998; 29:221–240.
• Gardner F, Burton J, Klimes I. Randomised controlled trial of a parenting inter- vention in the voluntary sector for reducing child conduct problems: out- comes and mechanims of change. J Clin Child Psychol Psychiatry 2006; 47:1123–1132.
• Webster-Stratton C. The Incredible Years Parents, Teachers, And Children Training Series: Residential Treatment for Children and Youth 2001; 18:31-46.
• Webster-Stratton C. Aggression In Young Children Services Proven To Be Effective In Reducing Aggression. University of Washington. Encyclopedia On Early Childhood Development. 2005
• Connolly L, Sharry J, Fitzpatrick C. Evaluation of a group treatment pro- gramme for parents of children with behavioural disorder. Child Psychol Psy- chiatry Rev 2001; 6:159–165.
• Reid MJ, Webster-Stratton C, Beauchaine TP. Parent training in head start: a comparison of program response among african american, asian american, caucasian, and hispanic mothers. Prevention Science 2001; 2:209–227.
• Barrera M Jr., Biglan A, Taylor T, Barbara K, Gunn B, Smolkowski K et al. Early elementary school intervention to reduce conduct problems: a randomized trial with hispanic and non-hispanic children. Prevention Science 2002; 3:83– 94.
• Hamilton M, Litterick-Biggs A. The Incredible Years parent training pro- gramme in tauranga, new zealand: a research summary. 2007 http://www.incredibleyears.com. Erișim Tarihi: 2.01.2009
• Webster-Stratton C, Reid JM, Hammond M. Treating children with early-onset conduct problems: intervention outcomes for parent, child and teacher train- ing. J Clin Child Adolesc Psychol 2004; 33:105–124.
• Psikiyatride Güncel Yaklașımlar – Current Approaches in Psychiatry
• eISSN 1309-0674 • ISSN 1309-0658 • www.cappsy.org • [e-mail]