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Families involved with the child welfare system struggle with high rates of child behavior problems, high levels of parenting stress and negative parenting attitudes. Behavioral parent training (BPT) programs have been found to be effective in addressing these issues in the general population but there is little evidence for the effects on maltreating parents. Only a few BPTs have been rigorously tested with this population, and existing studies focus on changes immediately following the intervention. Given the paucity of empirical studies, along with methodological limitations of existing evidence, it is unclear how effective BPT programs are and how long families can maintain gains from the intervention. The purpose of this study is to examine the effect of participation in Pathways Triple P on changes in child disruptive behaviors and parenting attitudes (stress, anger and self-efficacy) over 18 months among child welfare-involved families.
Methods:
This study used data from a longitudinal, randomized controlled trial study examining the effectiveness of an evidence-based BPT program, Pathways Triple P, among families referred by child welfare. Participants consisted of 144 caregivers with children between the ages of 3 and 12 years. Most caregivers were female (92%), African-American (66%), and married or living with a partner (67%). Over 90% of families in the study were eligible for free or reduced lunch Data were collected at four time points (baseline, post-intervention, 9 month follow-up, and 18 month follow-up), using the following standardized measures: Parent Anger Inventory, Parenting Stress Index, Parenting Sense of Competence, and Eyberg Child Behavior Inventory. Growth curve modeling was conducted, in SAS 9.4, to analyze the data. Missing values were imputed and parameter estimates were interpreted.
Findings:
Growth curve model analyses revealed that at each time point the treatment groups demonstrated increasingly better outcomes, relative to the control group, for a positive trajectory over the 18-month follow-up period. The comparison group scores were maintained or worsened. The interaction between time and condition was a significant predictor of child disruptive behaviors (b=-10.58, t=-2.17, p<.05), parent anger (b=-870, t=-2.24, p<.05), and parent stress (b=-3.84, t=-3.05, p<.05). Findings suggest that after controlling for all other variables in the model, parents who received Pathways Triple P reported less frequent child disruptive behaviors, lower levels of parent anger, and decreased parental stress 18 months after initiating the program, compared to the control group. There were no statistically significant interaction effects between time and condition on parenting self-efficacy.
Conclusions & Implications:
Study findings suggest that parent-mediated interventions, such as Pathways Triple P, produce promising maintenance of improvements in child behavior, parenting attitudes, and stress over time among families at risk for child maltreatment recurrence. This study expands the literature to date by providing longitudinal analysis of the effects of BPT on families in child welfare. Findings that support that gains were maintained highlight the need to provide effective BPT, such as Pathways Triple P, to families in child welfare.