Families Who Benefit and Families Who Do Not: A Family-Centered Approach to Parenting Intervention Effects

Background: It is well-known that not all families benefit equally from parenting interventions for reducing disruptive child behavior. Yet, decades of moderation research have provided limited insight into who the families are that benefit less or more. We therefore used a family-centered, as opposed to a variable-centered, approach to identify families who benefit. We hypothesize that parenting interventions benefit specifically families engaged in severe coercive interaction patterns, and not families with equally severe disruptive child behavior, but fewer parenting problems, or families with milder problems overall.

Methods: Families (N = 387) participated in a randomized controlled trial of the effects of the Incredible Years parenting intervention. Using a latent class growth model, we tested whether we could identify subgroups of families who show different trajectories (e.g., response versus non-response) of disruptive behavior from pre-intervention to 2.5 years post-intervention. Next, we tested whether the probability of showing response was larger for families engaged in coercive interaction patterns, than for families with severe disruptive child behavior, but fewer parenting problems, or families with milder problems.

Results: Most families (82%) showed a non-response trajectory. In these families, and similar to control families, disruptive behavior slightly decreased. Only 18% of the families showed a high response trajectory. In these families, and different from control families, disruptive behavior strongly decreased (Cohen’s d_{pretest to 2.5 year follow-up} = 1.45). As expected, families engaged in coercive interactions were 20% more likely to benefit than families with severe levels of disruptive child behavior, but fewer parenting problems, and 40% more likely to benefit than families with milder problems.

Conclusion: The Incredible Years parenting intervention is highly effective for a small subgroup of families. Specifically families for whom the intervention was designed–families engaged in coercive interactions—benefit. These findings suggest that parenting intervention effects can be optimized by selecting families not only based on disruptive child behavior, as is currently standard practice in many organizations, but based on a more comprehensive assessment of coercive family interactions.