Sequencing behavioral parent training: Do we need to start with positive parenting to be effective?

Voiceover

Presenter(s)

Anthony Arredondo

Abstract or Description

Behavioral Parent Training (BPT) is a leading, evidence-based intervention for children with behavioral and emotional concerns. Despite its effectiveness, challenges with outreach and accessibility persist, especially during high-stress periods such as the COVID-19 pandemic. In response to increased demand, our team developed a brief version of BPT featuring rolling admissions to improve access for families. This model allowed caregivers to begin treatment in either of the program’s two core modules—positive parenting or consequences—departing from the traditional sequence, which assumes that starting with positive parenting is essential for success.

This study explores whether the sequence in which families receive BPT affects treatment outcomes. We analyzed real-world data from 138 participants enrolled between 2020 and 2022. Outcomes assessed included treatment engagement, child disruptive behaviors, parenting confidence, and parenting stress. Results showed no differences in engagement, behavior, or confidence between groups; however, parenting stress was significantly lower in families who began with the consequences module.

These findings suggest that sequencing may not impact the overall effectiveness of brief BPT, and that allowing flexibility in module order may support caregiver engagement and reduce stress. Limitations include the lack of random assignment and the use of chart review data, which may introduce bias. A larger ongoing chart review involving over 800 cases aims to further evaluate these findings and inform future models of flexible, scalable BPT delivery.

Mentor

Dr. Jacob Holzman