Parenting Practice Changes during Parent Management Training Oregon Model with Parents of Children in Foster Care: A Growth Curve Analysis

Background/Purpose:

More than a quarter million children enter foster care each year and many do not achieve family reunification within 12 months (Children’s Bureau, n.d.). One strategy to improve reunification rates is research-supported parent training (e.g., Barth et al., 2009). Although parent training is expanding to the child welfare field, few studies have examined outcomes for biological parents who are working to reunify with their children while the children are in out-of-home care. As part of the federal Permanency Innovations Initiative, this study investigated changes in parenting practices among biological parents of children in foster care with serious emotional and behavioral problems, who were receiving Parent Management Training Oregon model (PMTO). Our research questions were:

1)      Did parents significantly improve their use of effective parenting practices?

2)      What was parents’ change trajectory on effective parenting?

3)      How was the change trajectory influenced by baseline parenting practices?

Method:

The study’s research design is quasi-experimental longitudinal with repeated measures. It represents a substudy of a larger randomized controlled trial of PMTO in a Midwestern state, and includes families randomly assigned and consented to PMTO during the summative evaluation (n=318). This study’s parenting data were not available on the control group.  The intervention group received up to 6 months (M=23 weeks) of in-home PMTO. PMTO clinicians administered the Parent Child Checklist (PCC) weekly. The PCC is an observation-based measure comprised of six subscales: encouragement, positive involvement, communication/monitoring, problem-solving, effective discipline, and ineffective discipline. Multiple imputation was used for missing data and latent growth curve modeling was conducted to examine change trajectories on overall parenting effectiveness and each of the six subscales.

Results:

Results indicated that parenting effectiveness improved, and a cubic model (2 change-trajectory) best fit the trajectory. Parenting practices initially improved; these improvements were followed by a temporary downward trend, and then recovered toward further improvements. While the subscales’ trajectories were either cubic or quadratic, all but one of six subscales (ineffective discipline) demonstrated significant change. Analyses of baseline parenting practices showed high initial scores were associated with lower rates of improvement and higher rates of deceleration. Yet, parents with relatively high rates of change maintained improvements over time.

Conclusions:

Results suggest that PMTO was associated with improvements in parenting practices among this sample of biological parents of children in foster care with serious emotional and behavioral problems. Importantly, changes in parenting practices were not linear, they were curvilinear. Thus, parents improved their parenting but they did so within the context of setbacks about mid-treatment. Administrators and practitioners should be cognizant of this up-and-down trajectory as possibly typical for biological parents of children in foster care. This study contributes to the evidence on parent training by examining the intervention in a real-world foster care setting and including biological parents who were working to reunify with their children. Future study of parent training must extend these longitudinal approaches to the post-reunification period and examine whether parenting improvements are sustained beyond the active treatment phase.