Predictors of Treatment Response Following Parent Management Training: Child, Context, and Therapy Factors

Parent Management Training- the Oregon model (PMTO) was introduced as a treatment alternative to families in both child welfare services and child psychiatric out-patient clinics in Norway, in 2001. PMTO is now one of the standard treatments offered in these public services, and is also the treatment of choice for families with children with behavioral problems. Since its introduction, many hundred families have received PMTO and numerous articles have been published about PMTO in Norwegian contexts. The focus of these studies includes the effectiveness of PMTO, implementation processes, and mediators and moderators of effect. The latest article examined a set of predictors of treatment response in families following parent management training (PMTO).

In this study, families of 331 Norwegian girls (26%) and boys with clinic-level conduct problems participated. The children ranged in age from 3 to 12 years (Mage =8.69). Retention rate was 72.2% at post-assessment. Child-, parent- and therapy-level variables were tested as possible predictors of multi-informant reports of changes in children’s externalizing behavior and social skills. Behavioral improvements in children, following PMTO amounted to 1 standard deviation on parent-rated, and ½ standard deviation on teacher-rated externalizing behavior. Improvements in social skills were more modest.

The results suggested that children with higher externalizing symptom scores and lower social skills scores at pre-treatment were more likely to show improvements in these areas. According to both parent- and teacher-ratings, girls tended to show greater improvements in externalizing behavior and social skills following treatment. Furthermore, according to parents, ADHD symptomology appeared to inhibit improvements in social skills. Finally, observed increases in parental skill encouragement, therapists’ satisfaction with treatment and the number of hours spent in therapy by children were also positive and significant predictors of child outcomes.

We would like to present the design, method and results of this study, along with a more general discussion about lessons learned when implementing an evidence-based treatment into regular, public services for children and families in Norway.