Stress Management Strategies for Parent-Child Relationships

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Florida International University

Disqualifiers: Sensory impairments, Motor difficulties, DCYF involvement

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: 5

Duration: 7 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether adding three extra stress-reducing sessions for parents can enhance the effectiveness of the School Readiness Parenting Program (SRPP) for families of children with disruptive behavior disorders. Researchers aim to determine if these sessions, based on cognitive behavioral therapy (CBT), can improve parent-child interactions and reduce parental stress. The study will compare families who only receive the SRPP with those who also receive the additional CBT sessions. Families with children who have ADHD or oppositional defiant disorder and face significant challenges at home and school may be well-suited for this trial. As an unphased trial, this study offers families the chance to contribute to innovative research that could improve parenting strategies and child outcomes.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on parent training sessions and does not mention medication changes.

What prior data suggests that these stress management strategies are safe for parent-child relationships?

Previous studies have shown that cognitive behavioral therapy (CBT) is safe and effective in reducing stress for parents. Research indicates that CBT significantly lowers parental burnout compared to those who do not receive the therapy. Additionally, CBT helps parents manage emotions better and use positive parenting techniques. This suggests that CBT is generally safe and well-received by parents who try it. These studies have reported no major serious side effects from CBT. Therefore, adding CBT sessions to the School Readiness Parenting Program is expected to be a safe choice for parents seeking to reduce stress and improve interactions with their children. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how combining Cognitive Behavioral Therapy (CBT) with a School Readiness Parenting Program can better address parenting stress. Unlike traditional programs that focus solely on behavioral management and school readiness, this approach adds targeted CBT modules to help parents manage their stress more effectively. By integrating these CBT techniques, the trial aims to offer a more comprehensive strategy to improve parent-child relationships, potentially leading to better outcomes for both parents and children.

What evidence suggests that this trial's treatments could be effective for improving parent-child relationships?

Research has shown that adding cognitive behavioral therapy (CBT) to parenting programs can greatly reduce stress for parents. One study found that family stress and the need to make adjustments to ease a child's distress significantly decreased when parents participated in CBT-based programs. Another study found that when parents participate in mental health treatments, children tend to have better outcomes. Additionally, CBT reduces stress and anxiety and improves parents' quality of life. In this trial, one group of participants will receive the School Readiness Parenting Program alone, while another group will receive additional CBT modules. These findings suggest that including extra CBT sessions in the School Readiness Parenting Program may effectively help parents manage stress and improve their interactions with their children. ^{3 4 6 7 8}

Are You a Good Fit for This Trial?

This trial is for parents of children with disruptive behavior disorders like ADHD. Participants should be interested in improving their parenting skills and reducing stress. They must have access to the internet to complete online surveys.

Inclusion Criteria

At-risk clinical range on the BASC-Preschool Version (per parent and teacher report) or clinical diagnosis of Attention-Deficit/Hyperactivity Disorder and/or Oppositional Defiant Disorder based on the Disruptive Behavior Disorders Scale or the Diagnostic Interview Schedule for Children

Parent and teacher report of significant levels of impairment at home and at school on the Impairment Rating Scale

Exclusion Criteria

Significant sensory impairments (e.g. deafness, blindness)

Families with current Department of Children and Family (DCYF) involvement

I have a condition like cerebral palsy that affects my ability to move.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Baseline Assessment

Parents and children undergo 2 hours of baseline assessments evaluating behavioral, cognitive, and academic functioning as well as parent-child interactions

1 day

1 visit (in-person)

Treatment

Participants receive a 7-week behavioral treatment and are randomized to either the School Readiness Parenting Program alone or with additional CBT sessions

7 weeks

Weekly sessions (1.5 to 2 hours each)

Follow-up

Participants are monitored for safety and effectiveness after treatment, with assessments at 6-month and 12-month intervals

12 months

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Cognitive Behavioral Therapy (CBT)

Trial Overview The study tests if adding three extra CBT-based sessions focused on stress management to the School Readiness Parenting Program helps reduce parent stress and improve interactions with their child, compared to just SRPP alone.

How Is the Trial Designed?

Group I: School Readiness Parenting Program + Cognitive Behavioral Therapy Experimental Treatment 3 Interventions

For those randomly assigned to the additional parenting stress modules, parents will receive the same SRPP as well as three additional modules to target parenting stress. The modules will incorporate practices based on Cognitive-Behavioral Therapy (CBT).

Group II: Traditional School Readiness Parenting Program Active Control 2 Interventions

Parents will be required to attend a School Readiness Parenting Program for 1.5 to 2 hours weekly. Sessions include behavioral management strategies and school readiness. Behavior management strategies are delivered to the entire group via a Community Parent Education Program (COPE) style modeling problem solving approach; parents contribute to the didactic discussion. The behavioral management content is derived from Parent-Child Interaction Therapy (PCIT).

Who Is Running the Clinical Trial?

Florida International University

Lead Sponsor

Trials

114

Recruited

19,400+

Published Research Related to This Trial

In a study involving 53 children with anxiety disorders, specific parent training techniques in family-based cognitive-behavioral therapy (FCBT) significantly improved children's overall functioning, particularly through parental anxiety management and transferring control from therapist to parent.

However, these parent training techniques did not show a significant impact on reducing child anxiety levels, indicating that while they may enhance global functioning, they might not directly address anxiety symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exploring the role of parent training in the treatment of childhood anxiety. Khanna, MS., Kendall, PC.[2018]

This study is testing a new enhanced cognitive behavioral therapy (CBT) intervention designed for both children and their parents with anxiety disorders, aiming to address the shared factors that maintain anxiety in the family dynamic.

The pilot trial will evaluate the feasibility and acceptability of this intervention with 10 parent-child dyads (20 participants total), using both qualitative and quantitative methods to assess symptom changes and participant feedback, which will help shape future larger-scale studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility and acceptability of an enhanced cognitive behavioural therapy programme for parent-child dyads with anxiety disorders: a mixed-methods pilot trial protocol. Galea, S., Salvaris, CA., Yap, MBH., et al.[2021]

Cognitive Behaviour Therapy (CBT) is recognized as a promising treatment for children and adolescents with psychiatric disorders, supported by a historical development and evidence of its effectiveness.

The article discusses both the current challenges and future potential of CBT, suggesting it will remain a key therapeutic option for mental health professionals working with young people.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Jack Tizard Lecture: Cognitive Behaviour Therapies for Children: Passing Fashion or Here to Stay? Graham, P.[2020]

Parental involvement in cognitive behavioral therapy (CBT) for anxious children enhances treatment efficacy, particularly for younger children and those with at least one anxious parent, as shown in a review of 13 studies.

Common therapeutic techniques involving parents include psychoeducation, cognitive restructuring, and improving parent-child relationships, while challenges such as parental psychopathology and unrealistic expectations can hinder treatment effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Parental involvement in cognitive-behavioral therapy for children with anxiety disorders]. Aydın, A.[2018]

The Parenting Mindfully (PM) intervention significantly increased mindfulness and reduced parenting stress among 83 mothers of adolescents, leading to improved parent-adolescent relationship quality.

The intervention was particularly effective for mothers of girls, decreasing negative parenting behaviors and emotional responses during parent-adolescent interactions, with medium to large effect sizes observed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parenting-focused mindfulness intervention reduces stress and improves parenting in highly-stressed mothers of adolescents. Tara M Chaplin, ., Turpyn, CC., Fischer, S., et al.[2022]

Mindfulness-based interventions, such as mindfulness-based stress reduction and cognitive therapy, have been shown to effectively improve parent-child relationships, particularly in families dealing with developmental disorders like autism and ADHD.

These approaches not only enhance the mental well-being of both parents and children but also foster better communication and interactions, leading to meaningful improvements in their daily lives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Parent-child relationships and mindfulness]. Yoshimasu, K., Oga, H., Kagaya, R., et al.[2019]

In a study of 128 clinically anxious children, 41% of those treated with child-focused cognitive-behavioral therapy (CBT) no longer met the criteria for anxiety disorders after treatment, compared to only 28% in the family-focused CBT group.

Child CBT was particularly more effective for children whose parents had anxiety disorders, while family CBT worked better for children whose parents did not have such disorders, highlighting the importance of parental mental health in treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Child versus family cognitive-behavioral therapy in clinically anxious youth: an efficacy and partial effectiveness study. Bodden, DH., Bögels, SM., Nauta, MH., et al.[2022]

A study analyzing 57 different parenting programs found that various combinations of behavior management (BM) with relationship enhancement (RE) were effective in reducing parental stress, with BM combined with RE being the most effective.

More comprehensive programs, such as those including multiple components like psychoeducation and parental self-management, were found to be less effective in reducing parental stress compared to simpler combinations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of parenting program components on parental stress: A systematic review and component network meta-analysis. Tehrani, HD., Yamini, S., Vazsonyi, AT.[2023]

A 20-session group supervision seminar effectively increased the knowledge and confidence of 22 community mental health practitioners in delivering cognitive behavior therapy (CBT) for children, demonstrating that such training can enhance access to this treatment.

Participants expressed a need for more structured training and suggested that future studies should include direct observation of their CBT skills to further refine the training model.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An innovative child CBT training model for community mental health practitioners in Ontario. Manassis, K., Ickowicz, A., Picard, E., et al.[2018]

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment that has been shown to effectively improve trauma symptoms in diverse populations of traumatized children and adolescents.

The TF-CBT model has been rigorously tested in various challenging research settings, demonstrating its efficacy and establishing it as a widely used intervention for childhood trauma.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trauma-focused cognitive behavioral therapy for children and families. Cohen, JA., Deblinger, E., Mannarino, AP.[2019]

In a study of 82 children aged 7-12 receiving parent-led cognitive behavioral therapy after trauma, lower educational achievement in parents was linked to a higher likelihood of non-completion of the treatment.

Unexpectedly, higher emotional reactions from parents regarding their child's trauma and greater perceived social support were associated with non-response, suggesting that parents may need additional emotional support to effectively help their children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent-led stepped care for traumatised children: parental factors that predict treatment completion and response. Fagermoen, EM., Skjærvø, I., Jensen, TK., et al.[2023]

A meta-analysis of 48 child psychotherapy studies found that combining parent-child therapy with individual child treatments leads to better outcomes, with a moderate effect size of 0.27.

Cognitive-behavioral individual treatments were found to be more effective when parents were involved, suggesting that parent participation enhances the overall effectiveness of child psychotherapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of parent participation on child psychotherapy outcome: a meta-analytic review. Dowell, KA., Ogles, BM.[2022]

Caregivers of children who underwent Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) reported high satisfaction with the treatment, averaging 30.59 out of 32 on the Client Satisfaction Questionnaire-8, indicating that they found the therapy effective and beneficial.

The study revealed that caregivers felt significantly less alone in dealing with their child's trauma after treatment, which was linked to their overall satisfaction, and they noted improvements in their parenting skills and relationships with their children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Caregiver Satisfaction and Perceptions of Trauma-Focused Cognitive Behavioral Therapy. Brumley, LD., Pollio, E., Cooper, B., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6732048/

Parent-Based Treatment as Efficacious as Cognitive ... Family accommodation and parenting stress were significantly reduced in both treatments, with significantly greater reduction in family accommodation following ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S0005789425000218

The Impact of Parental Cognitions on Outcomes ... Mothers' unhelpful cognitions predicted significantly less improvement in child conduct problems and internalizing problems, parenting stress, and observed ...

3. psychiatryonline.org psychiatryonline.org/doi/full/10.1176/appi.psychotherapy.20220025

Involving Parents in Child Mental Health Treatments Child therapy outcomes research has indicated that involving parents in child mental health treatments is generally beneficial.

4. bakercenter.org bakercenter.org/bpt-4

The Research Behind Parent-Based Interventions The research clearly displays to mental health professionals that parenting-based interventions are consistently effective and help facilitate ...

5. bmcpsychiatry.biomedcentral.com bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-023-05216-7

The effect of cognitive behavioral therapy on stress and ... Based on the results, group CBT is effective in reducing stress and anxiety and improving the quality of life of mothers of girls with precocious puberty ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9999161/

Cognitive behavioral stress management for parents Highlights. •. Compared to the control group the CBSM intervention contributed to a significant reduction in parental burnout.

7. cebc4cw.org cebc4cw.org/program/combined-parent-child-cognitive-behavioral-therapy-cpc-cbt/

Program › Combined Parent Child Cognitive Behavioral ... CPC-CBT helps the child heal from the trauma of the physical abuse, empowers and motivates parents to modulate their emotions and use effective non-coercive ...

8. kidsfirstservices.com kidsfirstservices.com/first-insights/the-role-of-parents-in-cognitive-behavioral-therapy-for-kids

The Role of Parents in Cognitive Behavioral Therapy for Kids Parental involvement plays a significant role in the success of CBT for children. Parents provide emotional support, encouragement, and practical assistance.