Evaluating clinically significant change in mother and child functioning: comparison of traditional and enhanced behavioral parent training.

Abstract

The Strategies to Enhance Positive Parenting (STEPP) program, an enhanced behavioral parent training (BPT) intervention, was developed to improve engagement in and outcomes following treatment for single-mother families of school-age youth with attention-deficit/hyperactivity disorder (ADHD). A previous randomized clinical trial of the STEPP program demonstrated that the intervention resulted in statistically significant improvements at the group-level in child oppositional behavior, various areas of child impairment, parental stress, and parenting behavior, relative to a wait-list control condition and a traditional BPT group. Despite benefits at the group-level, little is known about outcomes at the individual-level of enhanced BPT relative to traditional BPT for various child- and parent-level outcomes. The current study compares the extent to which traditional BPT and the STEPP program result in reliable change and recovery across various child- and parent-level outcomes in a sample of 80, 5-12 year old youth with ADHD (70% male). Analyses demonstrated the benefit of participating in either BPT treatment; and participation in the STEPP program compared to traditional BPT was associated with only minimal incremental clinical benefit. Results, as well as clinical and research implications for assessment and treatment of high-risk families of youth with ADHD enrolled in BPT are discussed.