Behavioral Parent Training for Disruptive Behaviors

(MATCH-DB Trial)

Overseen By Brendan F. Andrade, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Centre for Addiction and Mental Health

Disqualifiers: Pervasive developmental disorder, Autism, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 3 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

Duration: 8-12 weeks

200 Participants Needed

Trial Summary

What is the purpose of this trial?

This study will develop and test whether personalized profiles of children with Disruptive Behaviour Disorder (DBD) and their parents based on important psychological, emotional, and neuropsychological indicators predict their response to child cognitive behavioral treatment and Behavioral Parent Training.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Behavioral Parent Training for Disruptive Behaviors?

Research shows that Behavioral Parent Training (BPT) is effective in improving behaviors in children with ADHD, such as reducing inattention, hyperactivity, and impulsivity. It also helps reduce parental stress and improve parenting practices, making it a beneficial approach for managing disruptive behaviors. ^{1 2 3 4 5}

Is Behavioral Parent Training safe for humans?

Behavioral Parent Training (BPT) is generally considered safe for humans, as it is a widely recommended and evidence-based approach for managing disruptive behaviors in children, particularly those with ADHD. It focuses on improving parenting practices and reducing negative behaviors without involving medication or invasive procedures. ^{1 2 3 6 7}

How is Behavioral Parent Training different from other treatments for disruptive behaviors?

Behavioral Parent Training (BPT) is unique because it focuses on teaching parents specific techniques to manage and improve their child's disruptive behaviors, which can also reduce parental stress. Unlike some treatments that may involve medication or direct therapy with the child, BPT empowers parents to create positive changes in their child's behavior through structured guidance and support. ^{1 2 4 8 9}

Research Team

Brendan F. Andrade, PhD

Principal Investigator

Centre for Addiction and Mental Health

Eligibility Criteria

This trial is for children with Disruptive Behaviour Disorders like ADHD, Conduct Disorder, ODD (Oppositional Defiant Disorder), and related emotional issues. Their parents will also participate. The study requires detailed psychological profiles of both to predict treatment response.

Inclusion Criteria

Child has clinically severe impairment in the interpersonal relations (greater than 3), functioning in schoolwork (greater than 3), or total domains (greater than 15) on the Columbia Impairment scale

Parent is able and willing to participate in a group treatment

Child is borderline/clinically at risk on the Child Behaviour Checklist (CBCL) or Teacher Report Form (TRF) (T-score greater than or equal to 60 on Externalizing Problems composite scale or a T-score greater than or equal to 65 on the Oppositional Defiant Disorder and/or Conduct Disorder scales)

Exclusion Criteria

Parent behaviour or emotional functioning that make group participation not possible

I prefer one-on-one treatment.

I prefer to choose my own treatment.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive cognitive behavioral therapy (CBT) and Behavioral Parent Training (BPT)

8-12 weeks

Follow-up

Participants are monitored for changes in parenting competencies, skills, and child emotional and behavioral problems

6 months - 1 year

Treatment Details

Interventions

• Behavioral Parent Training

Trial Overview The study is testing Behavioral Parent Training as a treatment. It aims to see if creating personalized profiles based on psychological and neuropsychological factors can help predict how well children and their parents respond to the therapy.

Participant Groups

Group I: Multi-Component Child and Parent Cognitive Behavioral Therapy Experimental Treatment 1 Intervention

Parents and their children aged 6-12 with DBD who meet inclusion criteria.

Behavioral Parent Training is already approved in United States, European Union, Canada for the following indications:

Approved in United States as Behavioral Parent Training for:

• Disruptive Behavior Disorder
• Oppositional Defiant Disorder
• Conduct Disorder
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Anxiety with behavioral difficulties
• Disruptive Mood Dysregulation Disorder (DMDD)
• Intermittent Explosive Disorder (IED)

Approved in European Union as Parent Management Training for:

• Disruptive Behavior Disorder
• Oppositional Defiant Disorder
• Conduct Disorder
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Anxiety with behavioral difficulties

Approved in Canada as Behavioral Parent Training for:

• Disruptive Behavior Disorder
• Oppositional Defiant Disorder
• Conduct Disorder
• Attention-Deficit/Hyperactivity Disorder (ADHD)

Who Is Running the Clinical Trial?

Centre for Addiction and Mental Health

Lead Sponsor

Trials

388

Recruited

84,200+

Findings from Research

A study involving 92 parents of children with ADHD showed that brief training in either antecedent-based (AC) or consequent-based (CC) techniques significantly improved daily problem behaviors compared to a waitlist group.

Antecedent-based techniques were particularly effective in reducing inattention symptoms immediately after training and at a two-week follow-up, highlighting their importance in managing ADHD behaviors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Which Techniques Work in Behavioral Parent Training for Children with ADHD? A Randomized Controlled Microtrial. Hornstra, R., van der Oord, S., Staff, AI., et al.[2022]

Behavioral Parent Training (BPT) is an effective first-line treatment for children with ADHD under six years old and a recommended combination treatment for older children, showing significant improvements in problem behaviors like inattention and hyperactivity.

The study demonstrated that BPT significantly improved parenting practices, as evidenced by changes in Parenting Scale scores, indicating that it can reduce negative parenting behaviors and enhance outcomes for children with ADHD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does a Behavioral Parent Training Program for Parents of ADHD Children Improve Outcomes? A Pilot Project. Morgan, TC., O'Keefe, LC.[2021]

Behavioral parent training (BPT) is an effective treatment for ADHD, improving both child behavior and parenting practices, as well as reducing parenting stress and enhancing classroom behavior.

Despite its effectiveness, research on BPT for ADHD is less comprehensive than for other disorders like oppositional defiant disorder (ODD) and conduct disorder (CD), highlighting the need for further studies to understand factors affecting treatment outcomes, especially given the high comorbidity between ADHD and these disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancements to the behavioral parent training paradigm for families of children with ADHD: review and future directions. Chronis, AM., Chacko, A., Fabiano, GA., et al.[2019]

Behavioral parent training (BPT) significantly reduced the frequency and severity of problematic behaviors in children with ADHD, particularly in areas like chores, homework, and peer interactions, based on data from 304 parents.

Parents reported a notable decrease in stress related to parenting their child with ADHD after participating in BPT, indicating that this intervention not only helps children but also supports parental well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral Parent Training for ADHD Reduces Situational Severity of Child Noncompliance and Related Parental Stress. Ciesielski, HA., Loren, REA., Tamm, L.[2021]

Behavioral parent training (BPT) significantly enhances the effectiveness of routine clinical care (RCC) for children with ADHD, particularly in reducing behavioral and internalizing problems, as shown in a study of 94 children over 5 months.

While BPT + RCC improved behavioral issues, it did not significantly affect ADHD symptoms or parenting stress compared to RCC alone, suggesting that BPT may help limit the need for multiple medications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of behavioral parent training for children with ADHD in routine clinical practice: a randomized controlled study. van den Hoofdakker, BJ., van der Veen-Mulders, L., Sytema, S., et al.[2019]

A meta-regression analysis of 29 studies involving 2,345 parents showed that behavioral parent training for children with ADHD has small- to medium-sized positive effects on various parental outcomes, such as parenting competence and mental health.

Techniques that focus on manipulating antecedents of behavior and reinforcing desired behaviors were particularly effective, while higher dosages of psychoeducation were found to negatively impact parental outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meta-analysis: Which Components of Parent Training Work for Children With Attention-Deficit/Hyperactivity Disorder? Dekkers, TJ., Hornstra, R., van der Oord, S., et al.[2022]

Parent-mediated behavior modification programs are effective for addressing inappropriate behaviors in children, supported by extensive empirical evidence for both handicapped and normal children.

The review highlights the importance of considering both specific and general reservations when prescribing and implementing these programs, emphasizing the appeal of self-instructional approaches for parents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Procedures and problems in behavioral training for parents. Mcloughlin, CS.[2019]

The Brief Behavioral Intervention, a shorter version of parent management training, effectively reduced disruptive behavior in children aged 2-6.5 years, with significant improvements noted immediately after treatment and maintained at 6-month and 1-year follow-ups.

The study involved 120 children and showed lower attrition rates compared to typical treatment programs, indicating that this brief intervention may be more acceptable and sustainable for families.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment effectiveness of a brief behavioral intervention for preschool disruptive behavior. Axelrad, ME., Butler, AM., Dempsey, J., et al.[2021]

The Strongest Families Smart Website (SFSW) intervention, a Web-based parent training program combined with telephone coaching, showed good feasibility and high satisfaction rates among parents in both a randomized controlled trial (RCT) and a real-world implementation study, indicating its effectiveness in treating disruptive behavioral problems in children.

Discontinuation rates were significantly lower in the implementation group (12.4%) compared to the RCT group (22.4%), suggesting that the program is more likely to be completed in a primary health care setting, which enhances its accessibility and potential impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Web-Based Parent Training Intervention With Telephone Coaching for Disruptive Behavior in 4-Year-Old Children in Real-World Practice: Implementation Study. Ristkari, T., Kurki, M., Suominen, A., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Which Techniques Work in Behavioral Parent Training for Children with ADHD? A Randomized Controlled Microtrial. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Does a Behavioral Parent Training Program for Parents of ADHD Children Improve Outcomes? A Pilot Project. [2021]

3. United States pubmed.ncbi.nlm.nih.gov

Enhancements to the behavioral parent training paradigm for families of children with ADHD: review and future directions. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Behavioral Parent Training for ADHD Reduces Situational Severity of Child Noncompliance and Related Parental Stress. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of behavioral parent training for children with ADHD in routine clinical practice: a randomized controlled study. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Meta-analysis: Which Components of Parent Training Work for Children With Attention-Deficit/Hyperactivity Disorder? [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Procedures and problems in behavioral training for parents. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Treatment effectiveness of a brief behavioral intervention for preschool disruptive behavior. [2021]

9. Canada pubmed.ncbi.nlm.nih.gov

Web-Based Parent Training Intervention With Telephone Coaching for Disruptive Behavior in 4-Year-Old Children in Real-World Practice: Implementation Study. [2023]