Parent Training via CD-ROM: Using Technology to Disseminate Effective Prevention Practices

Abstract

Family-based prevention programs have demonstrated effectiveness in reducing risk factors for substance abuse. The lack of efficient methods for training staff and insuring treatment integrity and the limited time that program progenitors have for dissemination impede the spread of these programs. Additionally, there are barriers to families who use these programs such as stigma associated with a parent education or mental health approach, transportation and access difficulties, and inability to commit to months of treatment sessions. New developments in technology can surmount most of these barriers. The author describes a video-based interactive CD-ROM for training parents and families in child management and relationship enhancement skills. The program's development was based on two premises which are well-supported in the literature. One premise is that interactive videodisk programs increase knowledge and performance more efficiently than do standard methods of instruction. The other is that videotaped modeling of parenting skills is as effective in producing improvements in child behavior as are parent education discussion groups and parent training with a therapist. The CD-ROM program is self-administered, highly interactive, and brief, requiring no trained staff for its delivery. Users receives feedback about their choices from the computer, not a person, thus minimizing defensiveness. Controlled evaluations show improvements in knowledge and parenting skills, and reductions in child behavior problems. Many teens moved from the clinical range of behavior problems to the normal range after their mothers used the program. Replication efforts by service providers and universities are underway due to the program's ease of implementation and evaluation. Gaps in knowledge about this approach include general long-term effects, and, more specifically, how the program will affect ethnically diverse populations, how repetition and use by other family members affects outcomes, and how to overcome mental health professionals' resistance to the technology. Prevention practice can be improved with this approach since it can be disseminated relatively quickly and inexpensively, with very high treatment integrity. The convenience and lack of stigma can increase participation by parents prior to their becoming distressed by their children's behavior problems. Existing programs can incorporate and evaluate CD-ROM parent training, while new efforts will be encouraged by such an inexpensive program. Program changes, based upon research feedback, can be incorporated rapidly without the difficulty of retraining program staff.