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A $2 million grant awarded to Washington University in St. Louis, MO, will be used to evaluate a parent training program in the vulnerable child welfare population. The award from the National Institute of Child Health and Human Development will fund research regarding the Pathways Triple P program. Investigators will determine whether the program is effective when applied to families in the child welfare system, as compared with usual treatment.
State-run child welfare systems serve children suspected of being mistreated and their families, making this a high-risk group that could greatly benefit from intervention.
"Pathways Triple P teaches strategies to manage parental anger, challenges negative parental attributes for child misbehavior, and seeks to help parents identify the effect of harsh discipline on their children while identifying causes of harsh and critical parenting practices," said lead investigator Patricia Kohl, PhD, assistant professor in the George Warrn Brown School of Social Work at Washington University.
Triple P (Positive Parenting Program), created 30 years ago in Australia, works with parents to prevent behavioral, emotional and developmental problems in children from birth to age 16. Parent intervention is provided at five levels of increasing intensity. Level 1 offers education about local resources, and Level 2 involves individual or group consultation for those whose children have mild behavioral issues. Four-session training for parents of children with mild-to-moderate behaviors is available in Level 3, and eight to 10 sessions are provided for families with children who have more severe behavioral difficulties in Level 4. Level 5 provides individual help for families in conflict or those dealing with significant stress or depression.
The program has demonstrated success in other high-risk populations, but it has not been tested within the child welfare system, a population particularly susceptible to behavioral issues, according to Dr. Kohl.
"The majority of children enters the system due to abuse and/or neglect and may be at especially high risk of disruptive behavior problems. This further places them at risk for further adverse outcomes, including the development of conduct disorder and juvenile delinquency, violent delinquency and juvenile court involvement."
During the randomized, controlled trial, Dr. Kohl and colleagues will provide individual, in-home intervention to 70 families. Over a 21-month period, they will evaluate the families and 70 others who make up the control group.
The Triple P study will focus on three questions: How does the program impact disruptive behavior of children ages 5-10? Does it prevent maltreatment recidivism and, if so, how? How do the costs and benefits of the program compare with those of treatment as usual?
Maltreatment of children has a great financial cost as well as a human toll, according to Dr. Kohl. Both costs escalate for the many children whose behaviors persist into adulthood.
"It is critical that we identify the least costly means for effective intervention that achieves optimal outcomes with this population," she said. "Our inclusion of a cost-benefit analysis will allow us to inform state-wide policy and practice, including the potential large-scale uptake of an empirically supported intervention."
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