Parent–Child Groups for Externalizing Disorders: Outcomes, Sociodemographic Moderators, Attendance, and Attrition in a Real-World Setting

Abstract

ABSTRACTGroup-based parent training is a well-established, empirically supported treatment for externalizing problems, but few studies have examined the outcomes of this approach in real-world, clinically representative outpatient samples. In addition, many families experience barriers to program attendance in outpatient settings. The purpose of this study was to examine pretreatment to posttreatment clinical outcomes of parent training and child social skills groups, as well as sociodemographic moderators of group outcomes, attendance, and attrition, among a large, diverse sample of families attending 8-week group treatment at an outpatient pediatric hospital. Two hundred thirty-three children ages 4–10 years and their parent reporters participated in 28 concurrent parent–child groups. Parent pretreatment and posttreatment ratings of child disruptive behavior and related parental stress were available for 158 families (M child age = 7.25 years, SD = 1.54; 77.8% male). Children showed significant pretreatment to posttreatment reductions in parent-reported child behavior problems and related stress, with small to medium effect sizes. Results showed little variation by sociodemographic moderators. Pretreatment maternal stress experience was associated with retention in treatment among families with both mother and father reporters attending treatment sessions, whereas across all mother reporters a higher degree of pretreatment child-related stress was associated with increased likelihood of group attrition. Medicaid insurance status was associated with increased likelihood of attrition across the full sample of families. The clinical implications of these results and related practice points for enhancing implementation of and patient retention in outpatient parent–child groups are discussed.