(PS8-A3) Parents’ Acceptance and Preference of Child vs. Parent-focused Treatment for Disruptive Behaviors

Externalizing behaviors compose about half of all mental health referrals for children. Untreated, externalizing disorders (EDs) can lead to issues in adulthood, like substance abuse, criminality, and mental illness (Kazdin, 1987; Farrington & Welsh, 2008). Behavioral parent training (BPT) is an efficacious treatment that preventsand treats externalizing disorders. Nonetheless, dropout rates are high; approximately 26% of parents prematurely drop out of BPT (Chacko et al., 2016). Anecdotally, clinicians speculate that parents often expect minimal involvement in their child’s treatment for behavioral problems, perhaps contributing to premature termination. However, no studies have examined parents’ acceptability and preference for treatment involvement. The purpose of this study was to examine if child-focused treatment was significantly more acceptable or preferential to parent-focused treatment, and whether parenting style and severity of child behavior problems correlated with acceptability and preference.

Participants included 164 parents (55.5% female) of children, ages 3-8 (54.3% male, M_age = 5.47, SD = 1.66), who reported struggling with their child’s misbehavior. Recruited through online parenting groups, parents were randomly presented either a child-focused treatment vignette, based on the Coping Power Program, or a parent-focused treatment vignette, based on BPT. Parents then completed the Treatment Evaluation Inventory-Short Form (TEI-SF; Kelley et al., 1989) for each vignette to assess treatment acceptability. After reviewing both vignettes, parents completed the Eyberg Child Behavior Inventory (ECBI; Robinson et al., 1980) to assess severity of child behavior problems. Finally, parents completed the Parenting Scale (PS; Arnold et al., 1993) to assess parenting style.

Results found that while parents found both treatment approaches acceptable, parents significantly preferred child-focused treatment, χ² (1, 164) = 11.81, p < 01; 63.4% of parents preferred child-focused treatment.Furthermore, more lax parents found both treatments acceptable, but significantly preferred child-focused treatment, r(163)= -.18, p < .05. Additionally, the more severe a child’s behavioral problems, the more acceptable parents found both treatments; however, the more problematic parents perceived their child’s behavior, the more they preferred child-focused treatment, r(163)= -.22, p < .01. Given the parental preference for child-focused treatment, clinicians could provide more psychoeducation about the rationale for BPT, as well as frequently check in with families, particularly those with more lax parents and children with more severe behavioral problems. Likewise, perhaps clinicians could incorporate aspects of child-focused treatment (e.g., child-only skills sessions) to increase BPT engagement.