Symposia
Program / Treatment Design
Patty Leijten, Ph.D.
University of Amsterdam
Bussum, Noord-Holland, Netherlands
Introduction. Developmental pathways of child conduct problems are strongly shaped by parenting factors. Programs to support parents in managing children’s conduct problems are therefore the recommended strategy to prevent and treat children’s conduct problems. We now have various empirically supported programs and dozens of meta-analyses confirming their effects. Unfortunately, however, most of these programs have not found their ways to clinical practice. Many programs are too complex and costly to implement at scale, especially in lower-resource settings where families are most at risk for children’s conduct problems. Second, established programs tend to be ‘package deal’ multi-component programs that require substantial time and effort from families, and that are difficult to personalize because of uncertainty about which components might be safely changed or eliminated. To improve support for child conduct problems, we need to identify discrete intervention components, rather than comprehensive treatment protocols, that can be flexibly implemented in brief programs to effectively reduce children’s conduct problems.
Methods. Study 1 includes three meta-analyses based on two systematic literature reviews to identify parenting program components associated with stronger program effects (Meta-analysis 1); combinations of parenting program components associated with stronger program effects (i.e., network meta-analysis; Meta-analysis 2); and single parenting program components with direct, causal effects on child behavior (Meta-analysis 3). Study 2 includes a factorial experiment testing the relative effects of three brief single component parenting programs on children’s conduct problems.
Results. Meta-analysis 1 (156 RCTs) shows that mainly learning theory based techniques are associated with stronger program effects; Meta-analysis 2 (156 RCTs) shows programs with fewer components yield stronger effects; Meta-analysis 3 (19 experiments) suggests various components (e.g., time-out), but not others (e.g., child-led play) have unique causal effects on children’s conduct problems. Preliminary findings of the factorial experiment (N = 196) will be available in the summer of 2022.
Discussion. Program components to form the basis of brief effective parenting programs for children’s conduct problems can be identified and implemented successfully. Next steps for the field include building an evidence base of what components programs should include in order to optimize effects and minimize burden and costs.