An Open Trial for an E-Health Treatment for Child Behavior Disorders I: Social Acceptability, Engagement, and Therapeutic Process (original) (raw)


Behavioral parent training (BPT) programs are the first-line interventions for childhood disruptive behaviors. In light of the COVID-19 pandemic, adapting these programs to telehealth modalities is necessary to ensure continued services to children and families. This study evaluates the use of telehealth versus in-person modality to deliver the Helping Our Toddlers, Developing Our Children’s Skills (HOT DOCS) BPT. The study design was quasi-experimental with two nonequivalent groups: in-person HOT DOCS ( n = 152) and internet-HOT DOCS ( n = 46). Participants were caregivers of children ages 2–5 exhibiting disruptive behaviors. Pre- and post-intervention outcome measures were collected for child disruptive behavior and parenting stress and post-test only for consumer satisfaction. Multiple linear and Poisson regression models were performed to assess the effect of class modality on the outcomes. Child disruptive behavior and parenting stress post-test scores for in-person and telehea...

This randomized controlled trial examined the efficacy of Triple P Online Brief, a low-intensity online positive parenting program for parents of children with early onset disruptive behavior problems. Two hundred parents with 2-9-year-old children displaying early onset disruptive behavior difficulties were randomly assigned to either the intervention condition (n = 100) or a Waitlist Control group (n = 100). At 8-week post-assessment, parents in the intervention group displayed significantly less use of ineffective parenting strategies and significantly more confidence in dealing with a range of behavior concerns. These effects were maintained at 9-month follow-up assessment. A delayed effect was found for child behavior problems, with parents in the intervention group reporting significantly fewer and less frequent child behavior problems at follow-up, but not at post-assessment. All effect sizes were in the small to medium range. There were no significant improvements in observe...

This study explores the moderators affecting the success of an Internet-based and telephone assisted remote parent training intervention and compares them to an educational control group. We prospectively identified 464 parents who reported at a health check that their 4-year-old children showed elevated levels of externalizing behavior. The moderators explored included parental attention deficit and hyperactivity disorder (ADHD) and parental distress. The dependent variables were child externalization scores and self-reported parenting skills. The measures were completed at baseline, six and 12-months follow-up. The 232 families randomized to active treatment received 11 Internet-based training sessions with weekly phone calls from a coach. The other 232 families had access to a website that provided general positive parenting advice and one 45-minute phone-call from a coach. Using hierarchical linear models, we explored if the parental ADHD or parental distress modified the treatm...

The primary aim of the present study was to evaluate if previously reported treatment gains of a parent management training (PMT) program, administered via Internet, were retained from post to the 18-month follow-up. Another aim was to evaluate homework compliance as a predictor of short and long-term outcomes. Participants were parents of 58 children (3-11 years) with conduct problems who received a 10-week self-directed PMT program, with limited therapist support. Parents of 32 children (55.2 %) responded at all measurement point (baseline, post-test and follow-up) and analyses showed that child conduct problems continued to decrease during the 18-month period after the intervention whereas parenting skills deteriorated somewhat from post treatment. Pre- to post-treatment change in child conduct problems was predicted by parental engagement in homework assignments intended to reduce negative child behaviors. The findings provide support for the use of Internet-based PMT and stress...

There is a large gap worldwide in the provision of evidence-based early treatment of children with disruptive behavioral problems. To determine whether an Internet-assisted intervention using whole-population screening that targets the most symptomatic 4-year-old children is effective at 6 and 12 months after the start of treatment. This 2-parallel-group randomized clinical trial was performed from October 1, 2011, through November 30, 2013, at a primary health care clinic in Southwest Finland. Data analysis was performed from August 6, 2015, to December 11, 2015. Of a screened population of 4656 children, 730 met the screening criteria indicating a high level of disruptive behavioral problems. A total of 464 parents of 4-year-old children were randomized into the Strongest Families Smart Website (SFSW) intervention group (n = 232) or an education control (EC) group (n = 232). The SFSW intervention, an 11-session Internet-assisted parent training program that included weekly telepho...