Parent Training for Adolescent Mental Disorders

Overseen By Sandra Solove, MA

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Ohio State University

Disqualifiers: Not able to speak English

Compensation: Varies

Number of Visits: 6

Duration: 6 weeks

64 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate the effectiveness of a web-based parent training program, enhanced with group discussions, in supporting families when their teens return from psychiatric residential treatment. The program, called Parenting Wisely for Residential Treatment (PWRT), is compared to standard care to assess its impact on family dynamics, parental confidence, and teen behavior. Parents of adolescents who have been in psychiatric residential treatment and have internet access can participate. As an unphased trial, this study provides families with a unique opportunity to contribute to research that could enhance support for parents and teens during a crucial transition period.

Do I need to stop my current medications to join the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

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 prior data suggests that this parenting program is safe for families?

Research has shown that online programs like the Parenting Wisely Residential Treatment (PWRT) are generally safe and well-received. Studies have found these programs moderately improve teen behavior without causing significant problems. Parents using similar programs reported better family relationships and parenting skills, with no major safety issues. This suggests that PWRT is likely a safe choice for parents seeking to help their teens adjust after residential treatment. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Parenting Wisely Residential Treatment (PWRT) because it offers a fresh, tech-driven approach to supporting parents of adolescents with mental disorders. Unlike traditional treatments that often rely on in-person family therapy sessions, PWRT utilizes a series of ten web-based modules and weekly online discussion groups, making it more accessible and flexible for busy families. This method emphasizes empowering parents through easily accessible digital tools, potentially enhancing their ability to support their children effectively. By focusing on parent training in a convenient and interactive format, PWRT aims to improve adolescent mental health outcomes in a way that fits modern lifestyles.

What evidence suggests that this trial's treatments could be effective for adolescent mental disorders?

Research has shown that online programs like Parenting Wisely Residential Treatment (PWRT), one of the treatments in this trial, can help improve teen behavior. Studies have found that families in these programs experience fewer behavior problems in their children and develop better parenting skills. Specifically, families using Parenting Wisely improve in solving problems, understanding family roles, and engaging more with each other. These positive changes often persist for at least six months after completing the program. Overall, PWRT aids parents in supporting their teens' return home after residential treatment. ^{1 2 5 6 7}

Are You a Good Fit for This Trial?

This trial is for caregivers of adolescents aged 11-17 who are in psychiatric residential treatment. Caregivers must be able to communicate with the adolescent, speak English, and have internet access. Both the caregiver and the adolescent need to consent to participate.

Inclusion Criteria

I am between 11 and 17 years old.

Parent: The caregiver is allowed contact with the adolescent

My legal guardian has agreed and signed the consent form for me.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Parents complete web-based modules and attend facilitated discussion groups as part of the PWRT intervention

6 weeks

Weekly virtual discussion groups

Follow-up

Participants are monitored for changes in parenting practices, self-efficacy, and adolescent outcomes

6 months

Assessments at baseline, 6 weeks, and 6 months post-baseline

What Are the Treatments Tested in This Trial?

Interventions

• Parenting Wisely Residential Treatment (PWRT)
• TAU

Trial Overview The study tests a web-based parent training program called Parenting Wisely Residential Treatment (PWRT), enhanced with parent groups, against usual treatment. It aims to see if PWRT helps families function better and supports adolescents' mental health after they return home from intensive care.

How Is the Trial Designed?

Group I: Parenting Wisely Residential Treatment (PWRT) Experimental Treatment 1 Intervention

In the PWRT condition, parents will complete a total of ten web-based modules in an online parent training program called Parenting Wisely. Each week, parents will also attend a 90-minute facilitated discussion group via Zoom. Parents will complete assessments at baseline (T1), six weeks post-baseline (T2), and six months post-baseline (T3) via REDCap. While adolescents (n=60) will not directly receive the intervention, they will complete assessments at baseline, six weeks post-baseline (T2), and six months post-baseline (T3).

Group II: Treatment as Usual (TAU) Placebo Group 1 Intervention

The TAU condition is the standard of care offered to parents in RT settings. Parents in the TAU condition will receive traditional programming, including family therapy offered weekly during the RT admission. Parents will attend discharge planning meetings with caseworkers (if assigned) to discuss the adolescent's progress, continued treatment needs, safety plans, upcoming appointments, and medication needs. Following discharge, programs frequently recommend follow-up with an outpatient provider for medication management and therapy for the adolescent. Parents will complete assessments at baseline (T1), six weeks post-baseline (T2), and six months post-baseline (T3) via REDCap. While adolescents (n=60) will not directly receive the intervention, they will complete assessments at baseline, six weeks post-baseline (T2), and six months post-baseline (T3).

Parenting Wisely Residential Treatment (PWRT) is already approved in United States, Canada for the following indications:

Approved in United States as Parenting Wisely for:

• Improving family function
• Enhancing social support
• Increasing parental self-efficacy
• Improving parenting practices
• Reducing internalizing and externalizing behaviors in adolescents

Approved in Canada as Parenting Wisely for:

• Improving parenting knowledge
• Enhancing parental sense of competence
• Reducing child behavior problems

Who Is Running the Clinical Trial?

Ohio State University

Lead Sponsor

Trials

891

Recruited

2,659,000+

Published Research Related to This Trial

A web-based parent training program for caregivers of adolescents discharged from residential treatment was found to be acceptable and feasible, with 20 parents completing at least 80% of the modules and reporting ease of use and beneficial learning experiences.

While most parents found the program relatable and helpful, some felt the content did not fully address the severity of their adolescent's mental health challenges, indicating a need for tailored intervention content to better meet diverse needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Web-Based Parent Training in Parents with Adolescents Admitted to Psychiatric Residential Treatment: A Mixed-Methods Study. Herbell, K., Breitenstein, SM., Ault, S.[2022]

This pilot study aims to evaluate the feasibility and acceptability of Video Intervention Therapy (VIT) for improving parental reflective functioning (PRF) among caregivers of children hospitalized for psychiatric care, highlighting the importance of involving primary caregivers in treatment.

The study will assess both quantitative and qualitative outcomes, including changes in PRF, caregiver wellbeing, and children's functioning, contributing valuable insights for future family-based interventions in inpatient psychiatric settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Video feedback intervention to enhance parental reflective functioning in primary caregivers of inpatient psychiatric children: protocol for a randomized feasibility trial. Leyton, F., Olhaberry, M., Alvarado, R., et al.[2020]

Parent training programs, like The Incredible Years, are effective in reducing conduct problems in young boys, with significant improvements observed in parenting interactions and child behavior after 22 to 24 weeks of training.

Boys with both conduct and attentional problems benefited equally from the parent training, and those with higher attentional issues showed even greater reductions in externalizing behaviors, indicating that attentional problems do not hinder the effectiveness of this intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A growth curve analysis of parent training outcomes: examining the influence of child risk factors (inattention, impulsivity, and hyperactivity problems), parental and family risk factors. Hartman, RR., Stage, SA., Webster-Stratton, C.[2022]

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]

Parent management training is the most effective treatment for younger children with conduct disorder, while older children benefit from this training supplemented with problem-solving skills, both of which are supported by research.

Despite their effectiveness, these therapies face challenges such as high drop-out rates among parents and the fact that many youths improve but do not reach typical functioning levels, highlighting the need for ongoing monitoring and potentially more comprehensive prevention programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Behavior therapy in children with aggressive dyssocial disorders]. Brezinka, V.[2018]

The new intensive home treatment (IHT) model for adolescents with psychiatric issues allowed for the treatment of 125 patients per year, compared to only 70 patients under the previous long-term clinical admission model.

This IHT model significantly reduced the length of treatment to an average of 2 weeks of clinical admission and 4 months of outpatient care, resulting in lower costs (€28,000) while maintaining the same level of patient satisfaction as the previous model (€55,000).

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Intensive home treatment of adolescents in crisis: treat the parents along with 'psychiatric' adolescents]. Muskens, JB., Herpers, PC., van Velthuysen, M., et al.[2018]

The 'Connect' program, a ten-week intervention for parents of at-risk teens, significantly improved parenting satisfaction and reduced adolescents' aggression and antisocial behavior, with effects lasting up to 12 months after completion.

In a larger implementation involving 309 parents across 17 communities, the program led to notable reductions in both externalizing and internalizing problems in teens, as well as improvements in social functioning and affect regulation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of an attachment-focused manualized intervention for parents of teens at risk for aggressive behaviour: The Connect Program. Moretti, MM., Obsuth, I.[2022]

The Parent SMART intervention, which engages parents of adolescents in residential substance use treatment, showed preliminary effectiveness in improving parenting processes such as parental monitoring and communication during the 24 weeks post-discharge, based on a secondary analysis of a previous pilot study with 61 parent-adolescent dyads.

While participant-report questionnaires did not show significant changes, behavioral interaction tasks indicated that Parent SMART led to improvements in parenting scores, suggesting that this technology-assisted approach could be beneficial in supporting families during the transition period after treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent Smart: Effects of a Technology-Assisted Intervention for Parents of Adolescents in Residential Substance Use Treatment on Parental Monitoring and Communication. Becker, SJ., Helseth, SA., Janssen, T., et al.[2022]

A study involving 151 parent-child dyads in an inpatient clinic found that a novel parent training program improved parental mental health and parenting practices, but did not significantly affect child behavior problems compared to standard inpatient care.

The parent training showed benefits for parents post-training and at a 3-month follow-up, suggesting that while it may not directly change child behavior, it can enhance parental well-being, which could have long-term positive effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Universal parent training as a supplement to inpatient psychiatric treatment for children and adolescents. Schwenck, C., Schneider, W., Reichert, A.[2018]

The study is testing a technology-assisted intervention called Parenting Wisely+ (PW+) for parents of adolescents in residential substance use disorder treatment, aiming to improve post-discharge outcomes for these adolescents.

In a randomized pilot trial with 60 parents, the researchers will assess the feasibility and acceptability of PW+, as well as its impact on adolescent behaviors like substance use and truancy, potentially enhancing parental engagement and parenting practices that influence recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Technology-assisted intervention for parents of adolescents in residential substance use treatment: protocol of an open trial and pilot randomized trial. Becker, SJ., Hernandez, L., Spirito, A., et al.[2023]

Parent Management Training (PMT) is a well-researched treatment method for addressing oppositional, aggressive, and antisocial behaviors in children and adolescents, showing significant efficacy in controlled studies.

Despite its proven effectiveness, there are still unanswered questions regarding the long-term impact and overall effectiveness of PMT, highlighting the need for further research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent management training: evidence, outcomes, and issues. Kazdin, AE.[2022]

Behavioral parent training led to significant improvements in parenting behaviors for both mothers and fathers of 20 children with ADHD, indicating its efficacy in enhancing parental functioning.

Mothers experienced notable reductions in parenting stress, and even areas without statistically significant changes showed clinically meaningful improvements, highlighting the overall positive impact of the training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parental functioning in families of children with ADHD: evidence for behavioral parent training and importance of clinically meaningful change. Gerdes, AC., Haack, LM., Schneider, BW.[2015]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT05764369

Optimizing Residential Treatment Gains for Adolescents This hybrid group-based parenting program (called Parenting Wisely for Residential Treatment; PWRT) is designed to prepare parents for the reintegration of ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9629754/

Web-Based Parent Training in Parents with Adolescents ... A recent systematic review and meta-analysis concluded that web-based parent training programs have moderate effects on adolescent behavior ...

3. rgvhealthconnect.org rgvhealthconnect.org/promisepractice/index/view?pid=944

Promising Practices :: Parenting Wisely Findings from studies show an association between Parenting Wisely participation and improvements in family problem solving, family roles, family involvement, ...

4. familyworksinc.com familyworksinc.com/uploads/2/0/5/2/20527778/parenting_wisely_6_months_later.pdf

Parenting Wisely Six Months Later Results revealed that participants in both delivery formats reported significant decreases in child problem behaviors and significant increases in parental ...

5. preventionservices.acf.hhs.gov preventionservices.acf.hhs.gov/programs/868/show

Parenting Wisely – Teen Edition Parenting Wisely – Teen Edition is an interactive computer-based program that aims to improve parenting skills, reduce child behavior problems, and enhance ...

6. acf.gov acf.gov/sites/default/files/documents/cb/nccan14_workshop_14_handout.pdf

Parenting Wisely : Interactive CD-ROM Training for ... The program teaches parents of preadolescent and adolescent children important skills that lay the foundation for combating risk factors for substance use and.

7. bmjopen.bmj.com bmjopen.bmj.com/content/bmjopen/14/5/e080603.full.pdf

Families in transition (FIT) study protocol: feasibility, ... This study focuses on a hybrid parent training programme that combines Parenting. Wisely (PW), a web- based parent training with facilitated.