Preventative behavioral parent training in a primary care context: Initial evaluation of a universal prevention program for disruptive behavior disorders

Externalizing behavior problems such as noncompliance, tantrums, and aggression constitutes the most frequently cited reason for referral of young children to mental health clinics. The treatment for conduct problems (CP) that possesses the greatest amount of empirical support is referred to as behavioral parent training (BPT). Yet available data suggest that after accounting for treatment failures and dropouts, only about one third of children receiving BPT benefit significantly. More recently, there has been a shift towards the development of early intervention and prevention models for treating children at-risk for developing CP. While many of these programs have been shown to be effective, they fail to address shortcomings of BPT such as the length of treatment and the context of service delivery. Furthermore, the majority of these programs continue to be classified as selective or indicated prevention programs, thereby targeting children once they have already begun showing elevated levels of disruptive behaviors. More recently, a preventative and abbreviated version of BPT, called preventative behavioral parent training (PBPT), has been developed to address the limitations inherent in BPT. A recent evaluation of PBPT has demonstrated its utility in reducing rates of noncompliance and tantruming in children at-risk for developing CP. This study sought to add to previous findings regarding PBPT by evaluating its effectiveness when disseminated as a universal prevention program within a primary care setting. More specifically, this study aimed to evaluate whether PBPT could be utilized to support parents in learning effective strategies for managing their young child's typical misbehaviors, thereby preventing the development of clinical levels of CP and strengthening the practices of all parents. Results demonstrated that PBPT yielded positive outcomes in regards to both child and parent outcome variables. Furthermore, program evaluation data revealed that the PBPT program was socially acceptable and the strategies discussed were both feasible and effective. Taken together, the current study provides preliminary evidence of the positive proximal impact of the PBPT program. Potential clinical implications of these findings and future directions for research are discussed.