Journal Issue: Preventing Child Maltreatment Volume 19 Number 2 Fall 2009
Richard P. Barth
What Makes High-Risk Families Stay Involved in Parent Training Programs?
Although many programs aim to help parents avoid maltreating their children, hardly any are mandatory. For these programs to be effective, parents must be actively involved and want to change. Many studies have tried to find ways to help parents be more motivated to change.
Matthew Nock and Alan Kazdin administered a Participant Enhancement Intervention (PEI) to parents of oppositional, aggressive, antisocial children, giving each parent eight sessions with a therapist employing PEI, which is designed to “increase parents’ motivation to participate in treatment and to increase attendance and adherence to treatment.” 61 On the first, fifth, and seventh sessions the parents devoted about fifteen minutes to discussing their motivation to change and any barriers that were present. The therapist and the parent then worked together to develop a plan that would allow the parent to overcome the barriers and make a positive change. In a randomized control trial, parents who received PEI had greater treatment motivation, attended significantly more treatment sessions, and adhered more closely to treatment, according to both parent and clinician report. Because parents attended most of their sessions, it can be stated that PEI was effective in increasing their motivation.
Guided Self-Help and Parent Aide Models
Minnesota’s Early Childhood Family Education program has provided Minnesotans with support for the transition to parenthood for a third of a century. Its core program element is discussions in local community centers or elementary schools, though written materials are also available. The parent education discussions, available in almost every school district in Minnesota, are attended by about 300,000 parents of children from birth to age four each year. If families are isolated, parent educators bring the program to them. Parents, who meet with each other and with the educators, often indicate that although they enter the program for their children, they stay in it for themselves.62 During each session parents and children have “parent-child time,” structured activities overseen by the parent educator. Though it is the largest and oldest group support parenting program in the country, it has not been rigorously evaluated.
Peer support groups also help parents who are involved in child welfare services, but whose abuse cases have not necessarily been substantiated.63 After parents complete court-ordered parenting classes and other assigned programs, they have the option to enroll in an empowerment group consisting of professionals and peers who are or have been involved with child welfare services. Anecdotal evidence indicates that parents in these groups experience positive changes on a range of dimensions. Evidence is also becoming available about Parents Anonymous,© which has recently undergone a long-term single-group evaluation indicating significant reductions in the risks associated with child maltreatment.64 Circle of Parents,© another well-known support group intervention, is beginning to develop an evidentiary base (although the research conducted so far would not yet lift this program into the group generally known as “promising practices”).65
More than 100 home visitation programs provide services to parents at risk for abuse and neglect in twenty-eight states.66 Operated under the oversight of the National Exchange Club Foundation, each site offers a free home visitation program for parents involved with child welfare services; the goal is to reduce the cycle of abuse. Parents are referred to the program by child welfare services. Those who choose to participate are linked with a case manager and often a volunteer parent aide who conducts home visits. The aim of both is to build a relationship and become a positive mentor in the parent’s life. During weekly visits the aide targets individual areas of concern as well as parenting skills and also shares information about how to get services, such as housing, health care, and social services, that the parent requires. The program has been shown to be effective in reducing the number of subsequent referrals to child welfare services.67 Like most parent education programs aimed at preventing child abuse and neglect, it has not undergone rigorous evaluation.