TY - JOUR
T1 - Clinician-Identified Factors in Success of Parent-Directed Behavioral Therapy for Children’s Tantrums
AU - Yu-Lefler, Helen Fan
AU - Lindauer, Steven
AU - Riley, Anne W.
N1 - Funding Information:
The research outlined here was supported by the Kennedy Krieger Institute’s Department of Behavioral Psychology as part of routine treatment accountability practices in their outpatient programs.
Funding Information:
We thank the clinicians and clinical leadership at two outpatient behavioral therapy clinics at the Kennedy Krieger Institute for their commitment to treatment quality and participating as key informants in this study. We acknowledge the foundational efforts of the Director of the Department of Behavioral Psychology, Dr. Michael Cataldo, PhD, who supported and initially guided the investments to create the treatment accountability infrastructure within the outpatient behavioral psychology clinics. We also acknowledge Brittany Comunale and Leslie Wang, graduate students from the Johns Hopkins Bloomberg School of Public Health, who assisted in literature reviews.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/3
Y1 - 2022/3
N2 - Disruptive behavior disorders (DBD) are the most common behavioral health problems in young American children. When not well-managed in early childhood, DBD can progress to lifetime mental health problems with personal, economic, as well as societal impacts. The evidence-based intervention of choice for DBD is outpatient parent-directed behavioral therapy (PDT). However, little is known about clinicians’ perspectives on the factors influencing PDT’s effectiveness in routine care. The current study directly assesses clinicians’ perspectives on factors they believe impact PDT’s success for disruptive behavior problems, in particular tantrums, at two outpatient behavioral therapy clinics specializing in PDT. In-depth interviews with 19 clinicians across three experience levels (doctoral intern, post-doctoral, licensed staff psychologist) were conducted and analyzed using qualitative methods. Two major themes were identified as enabling and limiting treatment success: (1) appointment attendance, (2) primary caregiver buy-in to treatment approach. Additional identified factors include caregiver’s familial and social support, caregiver’s physical and emotional capacities, complexity of the child’s behavior problems, the extent to which the home environment can support positive changes, competing family/home demands, and care coordination among hospital programs. The primary factors identified by clinicians highlight the importance of fostering appointment attendance and parental psychoeducation that can be addressed by implementing multi-level administrative, training, and clinical initiatives to improve PDT’s real-world effectiveness for DBD.
AB - Disruptive behavior disorders (DBD) are the most common behavioral health problems in young American children. When not well-managed in early childhood, DBD can progress to lifetime mental health problems with personal, economic, as well as societal impacts. The evidence-based intervention of choice for DBD is outpatient parent-directed behavioral therapy (PDT). However, little is known about clinicians’ perspectives on the factors influencing PDT’s effectiveness in routine care. The current study directly assesses clinicians’ perspectives on factors they believe impact PDT’s success for disruptive behavior problems, in particular tantrums, at two outpatient behavioral therapy clinics specializing in PDT. In-depth interviews with 19 clinicians across three experience levels (doctoral intern, post-doctoral, licensed staff psychologist) were conducted and analyzed using qualitative methods. Two major themes were identified as enabling and limiting treatment success: (1) appointment attendance, (2) primary caregiver buy-in to treatment approach. Additional identified factors include caregiver’s familial and social support, caregiver’s physical and emotional capacities, complexity of the child’s behavior problems, the extent to which the home environment can support positive changes, competing family/home demands, and care coordination among hospital programs. The primary factors identified by clinicians highlight the importance of fostering appointment attendance and parental psychoeducation that can be addressed by implementing multi-level administrative, training, and clinical initiatives to improve PDT’s real-world effectiveness for DBD.
KW - Disruptive behavior disorder
KW - Implementation
KW - Outcomes improvement
KW - Parent management training
KW - Parent-directed behavioral therapy
KW - Routine care
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U2 - 10.1007/s10488-021-01155-1
DO - 10.1007/s10488-021-01155-1
M3 - Article
C2 - 34322820
AN - SCOPUS:85111535289
SN - 0894-587X
VL - 49
SP - 168
EP - 181
JO - Administration and Policy in Mental Health and Mental Health Services Research
JF - Administration and Policy in Mental Health and Mental Health Services Research
IS - 2
ER -