Going to Scale with Parent Training in Norway: What Have We Found and Where Should We Go?

To scale up evidence-based interventions for the prevention and treatment of child conduct problems in primary care settings, the program Early Initiatives for Children at Risk (Norwegian acronym; TIBIR) was developed. The program was designed to identify, prevent and treat child conduct problems as early as possible. TIBIR is based on Parent Management Training, the Oregon Model (PMTO) and consists of 5 interventions (3 parent training interventions, 1 teacher intervention, and 1 child intervention) targeting important social contexts for children (i.e., home, kindergarten, or school). The use of multiple interventions in multiple settings offers a flexible approach, tailoring intervention to level of problem severity and context. The Norwegian government finances the implementation and dissemination of TIBIR. Currently, more than 100 of 430 municipalities across all health regions in Norway have implemented TIBIR. This 20x20 gives a brief outline of the rationale behind TIBIR and its empirical foundation. By and large, findings suggest that the PMTO principles can be successfully transported across cultures, i.e., from the US to Norway, both when delivered as full-scale treatment and as short-term intervention. Moreover, despite increased heterogeneity of service providers and intake characteristics of the target group when PMTO was scaled up, no attenuation of program effects were detected. The presentation concludes with a discussion of how to secure implementation quality when parent training interventions are disseminated at a large scale with scarce resources.