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Alan E. Kazdin - One of the best experts on this subject based on the ideXlab platform.
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Parent Management Training for conduct problems in children: Enhancing treatment to improve therapeutic change
International Journal of Clinical and Health Psychology, 2018Co-Authors: Alan E. Kazdin, Adam Glick, Jennifer V. Pope, Ted J. Kaptchuk, Bernadette Lecza, Erin Carrubba, Emily Mcwhinney, Natasha HamiltonAbstract:Abstract Background/Objective: The study evaluated two variations of Parent Management Training (PMT) for children referred to treatment for oppositional, aggressive, and antisocial behavior. The goal was to evaluate the impact of multiple enhancements to optimize common and placebo factors to augment therapeutic change. Method: The families of all children (N=138, 39 girls and 99 boys, ages 6-13) received PMT. One half of the families were assigned to receive an enhanced version with multiple additions designed to increase bonding of the parent to the therapist, professionalism of treatment and setting, credibility of the intervention, and expectancies for therapeutic change. Assessment included multiple treatment outcome measures of the child (problem behaviors, psychiatric symptoms, social competence, and adaptive functioning) and parents (depression, stress, and family relations) showed marked improvements over the course of treatment, and several process measures (therapeutic alliance, credibility of the procedures, expectancy for change). Results: The results indicated that children and parents made marked improvement in all the treatment outcome measures. The vast majority of children fell within the normative range at posttreatment on problem and prosocial behaviors. The two treatment conditions were no different in outcomes for children or parents. Conclusion: PMT led to marked changes in treatment outcome.
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Pretreatment social relations, therapeutic alliance, and improvements in parenting practices in parent Management Training.
Journal of Consulting and Clinical Psychology, 2006Co-Authors: Alan E. Kazdin, Moira K. WhitleyAbstract:The authors examined the parent-therapist alliance in parent Management Training for children (N = 218; 53 girls and 165 boys, ages 2-14) referred clinically for oppositional, aggressive, and antisocial behavior. The interrelations of pretreatment parent social relationships, the parent-therapist alliance over the course of treatment, and improvements in parenting practices at the end of treatment were evaluated by different raters. As expected, the better the quality of the parent-therapist alliance, the greater the improvements in parenting practices by the end of treatment. Social relations of the parents prior to treatment were associated with the parent-therapist alliance during treatment and parental improvements at the end of treatment. The relation between the therapeutic alliance and improvement in parenting practices was partially explained by pretreatment parent social relations.
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parent Management Training treatment for oppositional aggressive and antisocial behavior in children and adolescents
2005Co-Authors: Alan E. KazdinAbstract:1. Introduction 2. Underlying principles and concepts 3. From principles to techniques: positive reinforcement 4. From principles to techniques: punishment and extinction 5. Characteristics of treatment 6. Evidence: key findings, strengths and limitations 7. Critical issues in applying and implementing treatment 8. Parent Management Training in perspective PARENT Management Training TREATMENT MANUAL 9. Pre-treatment introduction and orientation 10. Defining, observing and recording behaviour 11. Positive reinforcement: point incentive chart and praise 12. Time out from reinforcement 13. Attending and planned ignoring 14. Shaping and school program 15. Review and problem solving 16. Family meeting 17. Low-rate behaviours 18. Reprimands 19. Compromising (1st session) 20. Compromising (2nd session) 21. Skill review, practice, and termination
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Parent Management Training: Evidence, outcomes, and issues.
Journal of the American Academy of Child & Adolescent Psychiatry, 1997Co-Authors: Alan E. KazdinAbstract:ABSTRACT Objective To describe and evaluate parent Management Training (PMT) as a treatment technique for oppositional, aggressive, and antisocial behavior. Method Recent research is reviewed on the efficacy of PMT; factors that contribute to treatment outcome; the range of outcomes related to child, parents, and family; and variations of treatment currently in use. Limitations are also discussed related to the impact of treatment, clinical application, and dissemination of treatment. Results and Conclusions PMT is one of the more well-investigated treatment techniques for children and adolescents. Notwithstanding the large number of controlled studies attesting to its efficacy, fundamental questions remain about the magnitude, scope, and durability of impact.
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cognitive problem solving skills Training and parent Management Training in the treatment of antisocial behavior in children
Journal of Consulting and Clinical Psychology, 1992Co-Authors: Alan E. Kazdin, Todd Siegel, Debra C BassAbstract:This study evaluated the effects of problem-solving skills Training (PSST) and parent Management Training (PMT) on children (JV = 97, ages 7-13 years) referred for severe antisocial behavior. Children and families were assigned randomly to 1 of 3 conditions: PSST, PMT, or PSST and PMT combined. It was predicted that (a) each treatment would improve child functioning (reduce overall deviance and aggressive, antisocial, and delinquent behavior, and increase prosocial competence); and (b) PSST and PMT combined would lead to more marked, pervasive, and durable changes in child functioning and greater changes in parent functioning (parental stress, depression, and overall symptoms). Expectations were supported by results at posttreatment and 1 -year follow-up. PSST and PMT combined led to more marked changes in child and parent functioning and placed a greater proportion of youth within the range of nonclinic (normative) levels of functioning.
Terje Ogden - One of the best experts on this subject based on the ideXlab platform.
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Working alliance and treatment fidelity as predictors of externalizing problem behaviors in parent Management Training.
Journal of Consulting and Clinical Psychology, 2013Co-Authors: Silje Hukkelberg, Terje OgdenAbstract:OBJECTIVE The study investigated treatment fidelity and working alliance in the Parent Management Training-Oregon model (PMTO) and investigated how these relate to children's externalizing problem behaviors, as reported by parents and teachers. METHOD Participants were 331 Norwegian parents who rated the client-therapist working alliance at 3 time points (Sessions 3, 12, and 20). Competent adherence to the PMTO treatment protocol was assessed by PMTO specialists from evaluations of videotaped therapy sessions using the Fidelity of Implementation (FIMP) system (Knutson, Forgatch, & Rains, 2003). Parents and teachers reported children's problem behaviors at baseline and at the end of therapy. Structural equation modeling was used to analyze the repeated measures data. RESULTS Parents reported high and stable levels of alliance and fidelity from Time 1 to Time 3, with no correlational or direct relations between the 2. Treatment fidelity predicted reductions in parent-reported externalizing behavior, whereas working alliance was related to less change in problem behavior. Alliance and fidelity were unrelated to teacher-reported behavior problems. CONCLUSIONS The findings point to treatment fidelity as an active ingredient in PMTO and working alliance as a negative predictor of postassessment parent-reported externalizing behavior. More research is needed to investigate whether these findings can be replicated and extended beyond PMTO.
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Treatment Outcomes and Mediators of Parent Management Training: A One-Year Follow-Up of Children with Conduct Problems
Journal of Clinical Child & Adolescent Psychology, 2011Co-Authors: Kristine Amlund Hagen, Terje Ogden, Gunnar BjørnebekkAbstract:This effectiveness study presents the results of a 1-year follow-up of a randomized controlled trial of Parent Management Training. Families of 112 Norwegian girls and boys with clinic-level conduct problems participated, and 75 (67%) families were retained at follow-up. Children ranged in age from 4 to 12 at intake (M = 8.44). Families randomized to the control group received an active treatment alternative as would be normally offered by participating agencies. Multi-informant, multisetting outcome measures were collected and results from both intention-to-treat and treatment-on-the-treated analyses are presented. In two separate indirect effects models, assignment to Parent Management Training-the Oregon model predicted greater effective discipline and family cohesion at postassessment, which in turn predicted improvements in several child domains at follow-up.
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Treatment effectiveness of parent Management Training in Norway: A randomized controlled trial of children with conduct problems.
Journal of Consulting and Clinical Psychology, 2008Co-Authors: Terje Ogden, Kristine Amlund HagenAbstract:This study was a randomized control trial (RCT) of Parent Management Training--The Oregon Model (PMTO) in Norway. A sample representing all health regions of Norway and consisting of 112 children with conduct problems and their families participated in the study. Families were randomly assigned to either PMTO or a regular services comparison group. PMTO was delivered via existing children's services, and families were recruited using the agencies' regular referral procedures, making this the first effectiveness study of PMTO and the first RCT of PMTO conducted outside of the United States. Using a multiagent-multimethod approach, results showed that PMTO was effective in reducing parent-reported child externalizing problems, improving teacher-reported social competence, and enhancing parental discipline. Age level and gender modified the effects of PMTO treatment on other outcomes. In a path model, participation in PMTO was associated with improved parental discipline, and effective discipline predicted greater child compliance, fewer child-initiated negative chains, and lower levels of child externalizing problems. Findings are presented along with a discussion of the implications for practice and research and the challenges accompanying effectiveness trials.
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implementation of parent Management Training at the national level the case of norway
Journal of Social Work Practice, 2005Co-Authors: Terje Ogden, Marion S Forgatch, Elisabeth Askeland, Gerald R Patterson, Bernadette Marie BullockAbstract:This article describes early aspects of the nationwide implementation of an evidence‐based program (EBP) in Norway and the design for studying program fidelity over time. The EBP is the Parent Management Training, Oregon Model (PMTO). The project is a combination of a ‘top down’ initiative at the governmental and ministry level, and a ‘bottom up’ initiative from practitioners seeking effective interventions in the prevention and remediation of behavior problems in children and youth. The main components of the implementation strategy were to (a) establish a national implementation and research center; (b) provide for regional and local participation at county and municipal levels; (c) establish a comprehensive therapist recruitment, Training, and maintenance program; (d) create a network for collaboration, supervision, and quality control; (e) conduct clinical outcome research; and (f) study the implementation process. Following the Training of three successive generations of PMTO specialists, a study was...
Roy P. C. Kessels - One of the best experts on this subject based on the ideXlab platform.
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Transfer effects of errorless Goal Management Training on cognitive function and quality of life in brain-injured persons
NeuroRehabilitation, 2016Co-Authors: Dirk Bertens, Danielle H E Boelen, Roy P. C. Kessels, Luciano FasottiAbstract:BACKGROUND: Previous findings had shown that the addition of errorless learning to traditional Goal Management Training (GMT) resulted in superior results when Training everyday tasks in persons with executive deficits after brain injury. OBJECTIVE: To investigate the additional effects of an errorless GMT on cognitive function and quality of life after acquired brain injury. METHODS: This is a supplementary analysis of findings from an RCT in which 67 patients with executive impairments after acquired brain injury were randomly allocated to an experimental errorless GMT (n = 33) or conventional GMT (n = 34) to train two individually chosen everyday tasks. Objective cognitive function using neuropsychological tests, subjective cognitive complaints and quality of life using questionnaires were assessed before and after Training. RESULTS: No significant interaction effects between these three types of outcome measures and the two forms of GMT were found. Irrespective of treatment, performance on two executive tests (Modified Six Elements Test; p = 0.006, Zoo Map test; p = 0.001) improved and daily executive function problems as reported by the participants (EFI; p = 0.001) and proxies (DEX; p = 0.01) diminished. CONCLUSIONS: Besides the previously found superiority of errorless GMT when Training everyday tasks, additional improvements in cognition and quality of life did not differ between the two treatments.
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a randomized controlled trial on errorless learning in goal Management Training study rationale and protocol
BMC Neurology, 2013Co-Authors: Dirk Bertens, Danielle H E Boelen, Luciano Fasotti, Roy P. C. KesselsAbstract:Background Many brain-injured patients referred for outpatient rehabilitation have executive deficits, notably difficulties with planning, problem-solving and goal directed behaviour. Goal Management Training (GMT) has proven to be an efficacious cognitive treatment for these problems. GMT entails learning and applying an algorithm, in which daily tasks are subdivided into multiple steps. Main aim of the present study is to examine whether using an errorless learning approach (preventing the occurrence of errors during the acquisition phase of learning) contributes to the efficacy of Goal Management Training in the performance of complex daily tasks.
Brian Levine - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of goal Management Training in improving executive functions a meta analysis
Neuropsychological Rehabilitation, 2019Co-Authors: Vessela Stamenova, Brian LevineAbstract:ABSTRACTOur objective was to review the literature and quantitatively summarise the effectiveness of Goal Management Training® (GMT) (alone or in combination with other Training approaches) in impr...
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rehabilitation of executive functioning in patients with frontal lobe brain damage with goal Management Training
Frontiers in Human Neuroscience, 2011Co-Authors: Brian Levine, Charlene Oconnor, Gary R Turner, Susan Gillingham, Tom A Schweizer, Tom Manly, Donald T. Stuss, Ian H RobertsonAbstract:Executive functioning deficits due to brain disease affecting frontal lobe functions cause significant real-life disability, yet solid evidence in support of executive functioning interventions is lacking. Goal Management Training (GMT), an executive functioning intervention that draws upon theories concerning goal processing and sustained attention, has received empirical support in studies of patients with traumatic brain injury, normal aging, and case studies. GMT promotes a mindful approach to complex real-life tasks that pose problems for patients with executive functioning deficits, with a main goal of periodically stopping ongoing behavior to monitor and adjust goals. In this controlled trial, an expanded version of GMT was compared to an alternative intervention, Brain Health Workshop (BHW) that was matched to GMT on non-specific characteristics that can affect intervention outcome. Participants included 19 individuals in the chronic phase of recovery from brain disease (predominantly stroke) affecting frontal lobe function. Outcome data indicated specific effects of GMT on the Sustained Attention to Response Task (SART) as well as the Tower Test, a visuospatial problem solving measure that reflected far transfer of Training effects. There were no significant effects on self-report questionnaires, likely owing to the complexity of these measures in this heterogeneous patient sample. Overall, these data support the efficacy of GMT in the rehabilitation of executive functioning deficits.
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rehabilitation of executive functioning an experimental clinical validation of goal Management Training
Journal of The International Neuropsychological Society, 2000Co-Authors: Brian Levine, Ian H Robertson, Linda Clare, Gina Carter, Julia Hong, Barbara A Wilson, John S Duncan, Donald T. StussAbstract:Two studies assessed the effects of a Training procedure (Goal Management Training, GMT), derived from Duncan’s theory of goal neglect, on disorganized behavior following TBI. In Study 1, patients with traumatic brain injury (TBI) were randomly assigned to brief trials of GMT or motor skills Training. GMT, but not motor skills Training, was associated with significant gains on everyday paper-and-pencil tasks designed to mimic tasks that are problematic for patients with goal neglect. In Study 2, GMT was applied in a postencephalitic patient seeking to improve her meal-preparation abilities. Both naturalistic observation and self-report measures revealed improved meal preparation performance following GMT. These studies provide both experimental and clinical support for the efficacy of GMT toward the treatment of executive functioning deficits that compromise independence in patients with brain damage. (JINS, 2000, 6, 299‐312.)
Kevin Gournay - One of the best experts on this subject based on the ideXlab platform.
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effect of a medication Management Training package for nurses on clinical outcomes for patients with schizophrenia cluster randomised controlled trial
British Journal of Psychiatry, 2004Co-Authors: Richard Gray, Til Wykes, Melisa Edmonds, Morven Leese, Kevin GournayAbstract:Background Non-compliance attenuates the efficacy of treatments for physical and mental disorders. Aims To assess the effectiveness of a medication Management Training package for community mental health nurses (CMHNs) in improving compliance and clinical outcomes in patients with schizophrenia. Method Pragmatic randomised controlled trial. Sixty CMHNs in geographical clusters were assigned randomly to medication Management Training or treatment as usual. Each CMHN identified two patients on their case-load who were assessed at baseline and again after 6 months by a research worker. The primary efficacy outcome of interest was psychopathology, measured using the Positive and Negative Syndrome Scale (PANSS). Results Nurses who had received medication Management Training produced a significantly greater reduction in patients'overall psychopathology compared with treatment as usual at the end of the 6-month study period (change in PANSS total scores: medication Management -16.62, treatment as usual 1.17; difference -17.79; 95% CI -24.12 to -11.45; P <0.001). Conclusions Medication Management Training for CMHNs is effective in improving clinical outcomes in patients with schizophrenia.
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the effect of medication Management Training on community mental health nurse s clinical skills
International Journal of Nursing Studies, 2003Co-Authors: Richard Gray, Til Wykes, Kevin GournayAbstract:Abstract Background . There is evidence that compliance therapy improves treatment adherence and clinical outcomes in patients with schizophrenia. Community Mental Health Nurses (CMHNs) are ideally placed to deliver compliance therapy but require Training to develop the necessary clinical skills. Aim . To explore whether a brief medication Management Training package is effective in developing the compliance therapy skills of CMHNs. Method . The study had a within subjects repeated measures design. A representative sample of 52 CMHNs entered the study. They performed a role-play task pre- and post-Training that was videotaped and blind rated by an independent rater using the Cognitive Therapy Scale (CTS). Knowledge was assessed pre- and post-Training using a knowledge about medication Management questionnaire. Trainees also completed a satisfaction with Training questionnaire at the end of the course. Results . Following Training there was a statistically significant improvement in mean scores on the primary measure of skills, the CTS (mean pre-Training CTS-total score 13.88, mean post-Training CTS-total score 31.12; p Conclusions . In this uncontrolled study Training improved the medication Management skills of CMHNs.
