The project tests two online versions of parent management training (PMT), an evidence-based treatment (EBT) for children referred for oppositional, aggressive, and antisocial behavior. Despite the existence of effective interventions, such as PMT, an estimated 70% of children in need of services do not receive them. Practical and logistical problems can make traveling to a clinic to receive in-person treatment impossible. Online treatment offers a solution to this dilemma by significantly expanding access to necessary care and reaching families who are not being served by standard, in-person treatment. The current project seeks to evaluate the feasibility and initial efficacy of two versions of online PMT in reducing clinical dysfunction in a sample of ethnically diverse children (ages 6-12 years) referred for CD and ODD. The groups will vary in the type of therapist contact. One group (Full- contact PMT) is structured identically to standard, in-person PMT but uses a videoconference program to deliver treatment instead of requiring in-person sessions. Although they will not be in the same physical location, families and their therapists will see, hear, and interact with each other in real time. Families in the second group (Reduced-contact PMT) do not have face-to-face interactions with a therapist. Instead, they receive PMT through a comprehensive PMT website with written materials, video clips, and downloadable forms. In addition to therapeutic change in the children, the project evaluates the therapeutic alliance, perceived barriers that interfere with treatment acceptability, and participation in treatment. These latter domains will be evaluated because they have been shown to moderate therapeutic change and may operate differently in the different versions of online treatment (which may differ from traditional, in-person PMT). Findings from this study will inform and guide a large-scale RCT on the efficacy of online PMT and will facilitate longer-term objectives of the research program, namely, wider dissemination of EBTs to underserved populations in the United States (and elsewhere) and geographic areas that are not well served (e.g., rural areas). The findings will also have important implications for other treatments involving the use of the Internet and telepsychiatry/psychology in terms of therapeutic processes, ease of use, and client reactions.

Public Health Relevance

The research evaluates the use of online versions of delivering an effective psychological treatment for children clinically referred for serious oppositional, aggressive, and antisocial behavior. The goal is to develop models of delivery that reach families in need that are not being served by in-person treatment. The project has immediate implications for the treatment of children but more generally addresses several issues critical to treatments that are based on internet, telepsychiatry, and related technologies.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Planning Grant (R34)
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Interventions Committee for Disorders Involving Children and Their Families (ITVC)
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Sherrill, Joel
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Yale University
Schools of Arts and Sciences
New Haven
United States
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Rabbitt, Sarah M; Carrubba, Erin; Lecza, Bernadette et al. (2016) Reducing Therapist Contact in Parenting Programs: Evaluation of Internet-Based Treatments for Child Conduct Problems. J Child Fam Stud 25:2001-2020