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

60 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this randomized controlled trial is to determine the feasibility, acceptability, and preliminary effects of a web-based parent training (Parenting Wisely) augmented with facilitated parent groups (referred to as PWRT). PWRT is designed to prepare parents for the reintegration of their adolescents in the home after intensive psychiatric residential treatment. Researchers will compare PWRT to treatment as usual to determine whether PWRT effects target mechanisms (i.e., family function, social support, parental self-efficacy, parenting practices) and adolescent outcomes (i.e., internalizing and externalizing behaviors, placement restrictiveness).

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 data supports the idea that Parent Training for Adolescent Mental Disorders is an effective treatment?

The available research shows that parent management training, a form of Parent Training for Adolescent Mental Disorders, is one of the most effective treatments for conduct disorder in children and adolescents. It is well-researched and recognized as an effective therapy by the American Psychological Association. Additionally, the Connect Program, which focuses on improving parent-teen relationships, has shown significant reductions in teens' aggressive and antisocial behavior, as well as improvements in mental health and parenting satisfaction. These findings suggest that involving parents in treatment can lead to positive outcomes for adolescents with mental disorders. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment Parenting Wisely Residential Treatment (PWRT) for adolescent mental disorders?

Research shows that parent management training, a component of Parenting Wisely, is effective for conduct disorders in children and adolescents. Additionally, programs like the Connect Program, which focus on improving parent-teen relationships, have been successful in reducing aggressive and antisocial behavior in teens. ^{1 2 3 4 5}

What safety data exists for Parent Training for Adolescent Mental Disorders?

The research indicates that parent management training, a form of parent training, is well-researched and considered an 'empirically supported treatment' for conduct disorders in children and adolescents. It is effective for managing oppositional, aggressive, and antisocial behavior, and has shown statistically significant and clinically meaningful effects on parental functioning. However, limitations include high drop-out rates and some children not reaching normative functioning. No specific safety concerns are highlighted, but ongoing studies like FAST and LIFT report positive outcomes, suggesting a focus on optimizing treatment effectiveness. ^{1 6 7 8 9}

Is parent training for adolescent mental disorders safe for humans?

Parent training, which includes techniques like parent management training, is generally considered safe and is well-researched for treating conduct disorders and ADHD in children. However, some families may not see full benefits, and there can be a high drop-out rate among parents. ^{1 6 7 8 9}

Is Parenting Wisely Residential Treatment (PWRT) a promising treatment for adolescent mental disorders?

Yes, Parenting Wisely Residential Treatment (PWRT) is a promising treatment. It is a web-based program that helps parents support their adolescents in residential treatment. Parents find it easy to use and beneficial, as it helps them practice important skills and overcome barriers of in-person programs. It also improves parenting processes, which can lead to better outcomes for adolescents. ^{1 5 10 11 12}

How does the Parenting Wisely Residential Treatment (PWRT) differ from other treatments for adolescent mental disorders?

Parenting Wisely Residential Treatment (PWRT) is unique because it is a web-based parent training program that helps parents support their adolescents in residential treatment by overcoming barriers associated with in-person interventions, making it more accessible and engaging. ^{1 5 10 11 12}

Eligibility Criteria

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.

Exclusion Criteria

Parent and Adolescent: Not able to speak English

Timeline

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

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

2. Netherlands pubmed.ncbi.nlm.nih.gov

[Intensive home treatment of adolescents in crisis: treat the parents along with 'psychiatric' adolescents]. [2018]

3. England 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. [2020]

4. England pubmed.ncbi.nlm.nih.gov

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

5. United States 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. [2022]

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

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

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

Parental functioning in families of children with ADHD: evidence for behavioral parent training and importance of clinically meaningful change. [2015]

8. England 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. [2022]

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]

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

Web-Based Parent Training in Parents with Adolescents Admitted to Psychiatric Residential Treatment: A Mixed-Methods Study. [2022]

11. Germany pubmed.ncbi.nlm.nih.gov

Universal parent training as a supplement to inpatient psychiatric treatment for children and adolescents. [2018]

12. England 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. [2023]