Academic journal article Journal of Cognitive Psychotherapy

Cognitive Behavioral Parent Programs for the Treatment of Child Disruptive Behavior

Academic journal article Journal of Cognitive Psychotherapy

Cognitive Behavioral Parent Programs for the Treatment of Child Disruptive Behavior

Article excerpt

Although the therapeutic effectiveness of behavioral approaches to group parent programs in reducing child disruptive behavior has been established, about a third of all families do not benefit from participating. Because unhealthy/maladaptive emotions seem to be a primary reason why adults fail to engage in correct parenting practices and fail to benefit from behavioral parent programs, the key would be to bring together the cognitive and behavioral models of self-regulation to improve the outcomes of parental interventions for child disruptive behavior. Research in cognitive science (see David, 2004) seems to support the idea that both cognitive and behavioral elements need to be implemented in a structured way in parent programs, and focus should change from parental cold cognitions, which do not automatically result in parents' emotional response unless appraised, to hot parental cognitions. This article proposes changes in parenting interventions for child externalizing behavior based on advances in cognitive behavioral theory (CBT).

Keywords: cognitive behavioral parent program; child disruptive behavior; parental distress; cold and hot cognitions

Because there is no state license required, we are rarely trained in the most important task of our lives, namely, raising our children. It is widely accepted (see Children's Law Office- Beebe James) that adult parenting behaviors are modeled based on parents' childhood experience, and that both positive and negative family experiences while growing up have a direct impact on the attitudes and practices parents will use in raising their own children. When using the term parent program in this article, we will refer to the group-based programs in which the parents are included with the aim to actively acquire parenting skills (see Kazdin, 1993; Sanders, Markie-Dadds, Tully, & Bor, 2000).

The evidence that parents have an important role in maintaining children disruptive behavior has led to behaviorally based programs for parents. Behavioral approaches to parent training (BPT) have been investigated over the last 30 years, and their therapeutic efficacy and/ or effectiveness in reducing child disruptive behavior is established (Barlow & Stewart-Brown, 2000; Nixon, 2002). BPT are based on classical and operant learning theory and uses the constructs of positive reinforcement, extinction, time-out and contingency contracting, and so on (Kazdin, 1993). The aim is to reinforce alternative positive behaviors and to reduce unwanted negative behaviors. Although short-term outcomes are good (Webster-Stratton, Kolpacoff, & Hollingsworth, 1988), long-term benefits of BPT are unknown, and the few longer term follow-up studies suggest that 30% of those who show significant improvement remain in the clinically impaired range of functioning (see Doubleday & Hey, 2004; Kazdin, 1993; Webster-Stratton, 1990a, 1990b). These programs also typically report high rates of premature dropout, adding up to a quarter and half of those referred, according to critical reviews that have analyzed information from various studies (see Assemany & McIntosh, 2002). Moreover, research suggests (see Potier & Day, 2007), considering the fact that a third of all families do not benefit from these programs (see Hartman, Stage, & Webster-Stratton, 2003; Scott, 2001; White, McNally, & Cartwright-Hatton, 2003), that this might be not only because we have to do a better job to engage parents in the already existing evidence-based parent programs, but also that some important components that are fundamental to parenting practices may be missing from these parent programs (Greenberg, Speltz, DeKlyen, & Endriga, 1991; Potier & Day; Sutton, 2001).

Full integration of cognitive components into behavioral programs has had enormous benefits in adult populations for various psychological disturbances (see David, 2004). Because parent programs are working directly with adults, one would expect similar benefits with parents on impacting their self-regulation abilities. …

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