sanders etal 2004

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BEnAVtORTHERAPY35,513--535, 2004

Do es Parental Attr ibutional Retraining and A nger

M ana gem ent Enhance the Effects of the

Tr ip le P Po sit ive Parent ing Pro gram W ith

Parents at R isk of C hi ld Maltreatm ent?

M A T T H E W R . S A N D E R S

A I L E E N M . P ID G E O N

The University of Q ueensland

F R E D G R A V E S T O C K

Abused Child Trust Brisbane

M A R K D . C O N N O R S

S A M A N T H A B R O W N

R o s s W YO UNG

The University o f Queensland

Ni ne t y -e i gh t pa re n t s e xpe r i e nc i ng s i gn i f i c a n t d i f f i c u l t i e s i n ma na g i ng t he i r own

anger in the i r in te rac t ions wi th the i r preschool -aged chi ldren were randomly as-

s igned e i the r to an en hanced group-adminis te red behaviora l fami ly in te rvent ion pro-

gra m based on the Triple P- Po si t i ve Parenting Progr am that incorporated at tributional

re t ra in ing and anger managem ent EBFI) or a s tandard behaviora l fami ly in tervent ion

prog ram SBF I) that prov ided tra ining in parenting skil ls a lone. At post-interven tion,

both condi t ions were assoc ia ted wi th lower leve ls of obse rved and pa rent - repor ted

dis rupt ive chi ld behavior , lower leve ls of pa rent - repor ted dysfunc t iona l pa rent ing ,

grea ter parental self-efficacy, less parental distress, relationship con flict and sim ilarly

This s tudy was supported by grants f rom the Na t iona l Cent re for the Prevent ion of Chi ld

Abuse NC P C A ) a nd Q ue e ns l a nd He a l t h . W e g ra t e fu ll y a cknowl e dge t he a s s is t anc e o f t he fo l -

lowing pe rsons in the de l ive ry of the rapeut ic in te rvent ions and in the col lec t ion and coding of

obse rva t iona l , in te rv iew, and pa rent - repor t da ta: Jenni fe r Barbour , An i ta Blake ley-Sm i th , Bar-

ba ra De ve n i sh -Me a re s , Ke l l i e C u l l e n , S a ra h D wye r , B ronw yn F ow l e r , Di vna H a s l a m, Lohsna h

Je e va na nda m, C a ro l i ne Johnson , La u re n Ka l i kow, He ba a t Ka ra m, J a n i ne Lonsda l e , Anne t t e

Mc C a r t hy , L i nda Mc G ui re , Ma l a Mc H a l e , P h i li ppa Mc Ta gga r t , A l i na Mora wska , S araa n Mor -

t on , E l iz a be t h P a ga n , Ve n-n i c e R ya n , E mm a S a nde r s , Edw i na S ha l l c ros s , a nd Ma t t he w W oo .

Addre s s c o r re sponde nc e t o M a t the w R . S a nde r s , S c hoo l o f P syc ho l ogy , The Un i ve r s i t y o f

Queen s land, Bri sbane , Aust ra l ia , 4072; e -mai l : ma t t s@psy .uq.edu.au o r tr ip [email protected] .

513 005-7894/04/0513~)53551.00/0

Copyright 2004 by Association or Advancementof BehaviorTherapy

All rights for reproduction in any fo rm reserved.


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514 S ANDER S ET AL.

high leve ls of consu mer sa t is fac t ion . EB FI show ed a s igni f icant ly grea te r shor t - te rm

imp rovem ent on measures of nega t ive pa renta l a tt ribut ions for chi ldren s misbehav -

ior , potent ia l for chi ld abuse and unrea l i s t ic pa renta l expec ta t ions than SBFI. At

6 -mon t h fo l l ow-up bo t h c ond i t ions showe d s i mi l a rl y pos i ti ve ou t come s on a l l me a -

sures of chi ld abuse potent ia l , pa rent prac t ices , pa renta l adjus tment , and chi ld be -

ha v i o r a nd a d j us t me n t; how e ve r , EB F I c on t i nue d t o show g re a te r c ha nge i n ne ga t i ve

parenta l a t tr ibutions . Imp l ica t ions for t a i lor ing ea r ly- in te rvent ion programs to the

needs o f pa rents a t r i sk of chi ld mal t rea tmen t a re d i scussed .

As in mo s t Wes tern coun t r ies ch i ld abuse i s a majo r soc ia l and hea l th i s sue

i n Au s t r a li a , w i t h o v e r 2 5 ,0 0 0 s u b s tan t ia t ed ca s e s o f m a l t r ea t m en t each y ea r

(Aus t ra l i an Ins t itu te o f He al th and W el fare [AIH W ], 2000) . Ch i ld m al t rea t -

m en t , in i ts b roades t sense , can be def ined as a fa i lu re to p ro tec t the ch i ld

f rom h arm and a fa i lu re to p rov ide the pos i tive aspec t s o f a paren t -ch i ld re la -

t ionsh ip tha t can fos te r deve lopm ent (W eker le & Wo lfe , 1996, p. 492) . From

1998 to 1999, parents ( including natural , step- , an d de-fac to parents) ac cou nted

fo r 82% of a l l the persons be l ieved to be respons ib le fo r perpe t ra t ing the sub-

s tan t ia ted cases o f ma l t rea tm en t in Au s t ra l i a (AIHW , 2000).

The consequences o f ch i ld m al t rea tmen t a re bo th im me dia te and fa r -reach ing .

Sev e re p h y s i ca l an d h ea l t h co n ce rn s m ay s t em d i r ec t l y f ro m t h e ab u s i v e

ex p e r i en ce an d i n c l u d e b ra in d a m ag e an d d ea t h ( J am es , 1 99 4a ). A v a r i e ty o f

psych ia t ri c p rob lems m ay a l so deve lop over t ime, inc lud ing anx ie ty and depres -

s ive d i so rders (Haugaard , Reppucc i , & Feer ick , 1997) ; aggress ion and v io -

lent behavior (Hau gaard et a l ., 1997); sel f-harm ing behav ior (Nat ional Re searc h

Co unci l [N RC ], 1993); a nd su ic ida l idea t ion (S i lver rnan , Reinh erz , & Giaco-

n ia , 1996). O ther seque lae inc lude cogn i t ive de lays and learn ing d i f f i cu l ti es

(H aug aard et a l ., 1997); poo r social relat ionsh ips (Ha uga ard et a l . , 1997); and

s u b s tan ce ab u s e (NR C , 1 99 3) . F i n a l ly , th e cy c l e o f v i o l en ce m ay co n t i n u e

wi th the in te rgenera t iona l t ransmiss ion o f mal t rea tmen t once the v ic t im reach es

adu l thoo d (NRC , 1993).

Th e l i te r a t u re o n t h e p rev en t i o n o f ch i l d ab u s e h as em p h as i zed t h e i m p o r -

tance o f paren t ing sk i ll s in te rven t ion to address the def ic i t s in ch i ld m anag e-

ment sk i l l s o f ten found in abus ive paren t s (Black , Heyman , & Slep , 2001) .

These def ic i t s inc lude the use o f coerc ive and pun i t ive paren t ing s t ra teg ies

tha t in tens i fy and perpe tua te ch i ld behav io r p rob lem s , and increas e the l ike-

l i h o o d o f ch i l d m a l t r ea t m en t i n t h e f am i l y . B eh av i o ra l f am i l y in t e rv en ti o n s

(BFI) , based on soc ia l l earn ing p r inc ip les , a re increas ing ly cons idered an

es s en t i a l co m p o n en t o f ch i l d ab u s e p rev en t i o n an d t r ea t m en t i n t e rv en t i o n s

(Chalk & King , 1998).

BFIs a re am ong the m os t ex tens ive ly eva lua ted in te rven t ions ava ilab le to

ass i s t ch i ld ren wi th conduct p rob lems (Bres tan & Eyberg , 1998) . Typ ica l ly ,

paren t s a re t augh t to increase pos i t ive in te rac t ions wi th ch i ld ren and to

red u ce co e rc i v e an d i n co n s i s ten t p a ren ti n g p rac t i ce s. A v a r i e ty o f d i f f e r en t

d e l i v e ry fo rm a t s h av e b een d em o n s t r a t ed to b e e f f ec t iv e , i n c l u d in g i n d iv i d u -

a l ly ad m i n i s te r ed f ace - t o - face p ro g ram s ( e .g . , Fo reh an d & M cM ah o n , 1 98 1) ,

g roup p ro gram s (e .g . , W ebs ter -S t ra tton , 1990) , t e lephone-ass i s ted p rograms


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PARENTAL ATTRIBUTION RETRAINING AND ANGER MANAGEMENT 5 5

( e .g . , C o n n e l l , S a n d e r s , M a r k i e - D a d d s , 1 9 9 7) , a n d s e l f -d i r e c te d p r o g r a m s

( e .g . , M a r k i e - D a d d s S a n d e r s , 2 0 0 2 ) . T h e s u c c e s s o f B F I h i g h l i g h ts t h e

i m p o r t a n c e o f i n c l u d i n g p a r e n t i n g i n t e r v e n ti o n s i n a n y c o m p r e h e n s i v e p re -

v e n t i v e i n te r v e n t i o n d e s i g n e d t o p r e v e n t c h i l d m a l t r e a t m e n t a s a b u s iv e p a r e n t s

o f t e n r e p o r t s i g n i f ic a n t c o n d u c t p r o b l e m s i n t h e i r c h i ld r e n .

A l t h o u g h t h e r e i s l e s s p a r e n t t r a i n i n g r e s e a r c h w i t h m a l t r e a t i n g p a r e n t s ,

a v a i la b l e e v i d e n c e s u g g e s t s t h a t p a r e n t t r a in i n g l e a d s t o i m p r o v e m e n t s in

p a r e n t i n g c o m p e t e n c e a n d b e h a v i o r , a n d t h a t th e s e c h a n g e s a r e a n i m p o r t a n t

a s p e c t o f m i n i m i z i n g t h e r i s k f o r f u r th e r a b u s i v e b e h a v i o r , r e p o rt s t o p r o t e c -

t i v e a g e n c i e s , a n d v i s it s to h o s p i t a l ( J a m e s , 1 9 9 4 b ) . W h i l e p a r e n t i n g i n t e r v e n -

t i o n s a p p e a r t o b e h e l p f u l f o r m a l t r e a t in g f a m i l ie s , t h e y m a y o n l y a d d r e s s p a r t

o f a m u c h l a r g e r p r o b l e m w i t h f a m i l y in t e r a c t io n s ( A z a r , 1 9 9 7 ) . T h e c o m p l e x

n a t u r e o f c h i ld m a l t r e a t m e n t a n d t h e m u l t i p l e n e e d s o f p a re n t s h a v e l e d m a n y

i n v e s ti g a to r s to a r g u e f o r m o r e c o m p r e h e n s i v e in t e r v e n t io n s , r a t h e r t h a n r e l y i n g

s o l e l y o n p a r e n t i n g s k i ll s tr a i n i n g ( A z a r , 1 9 9 7 ) . T w o a r e a s t h a t h a v e r e c e i v e d

p a r t i c u l a r a t t e n t i o n i n c l u d e t a r g e t i n g p a r e n t s ' n e g a t i v e a t t r i b u t i o n s f o r c h i l d

b e h a v i o r a n d p a r e n t s ' a n g e r - c o n t r o l d e f ic i ts ( W h i t e m a n , F a n s h e l , G r u n d y ,

1 9 8 7 ) . T h e s e c o g n i t i v e a n d a f f e c t iv e f a c t o rs d i f f e r e n t i a t e b e t w e e n m a l t r e a t i n g

p a r e n t s a n d o t h e r p a r e n t s ( S t e r n A z a r , 1 9 9 8 ) .

T h e r e i s s o m e e v i d e n c e s h o w i n g a r e l a t io n s h i p b e t w e e n p a r e n t s ' d y s f u n c -

t i o n a l a t tr ib u t io n s a n d n e g a t i v e o u t c o m e s f o r c h i l d r e n ( B u g e n t a l , 2 0 0 0 ) . P a r e n -

t a l a t tr i bu t io n s a r e p r o p o s e d t o m e d i a t e t h e r e l a t i o n s h ip b e t w e e n c h i l d m i s -

b e h a v i o r a n d p a r e n t a l r e s p o n s e t o t h is b e h a v i o r ( S l e p O ' L e a r y , 1 9 9 8 ).

M a l t r e a t i n g p a r e n t s t e n d t o h o l d d i s t o r t e d b e l i e f s a n d u n r e a l i s ti c e x p e c t a t i o n s

r e g a r d i n g t h e d e v e l o p m e n t a l c a p a b il it ie s o f c h i l d r e n , th e a g e - a p p r o p r i a t e n e s s

o f c h i l d b e h a v i o r s , a n d t h e i r o w n b e h a v i o r w h e n i n t e r a c t i n g w i t h c h i l d r e n

( B l a c k e t a l . , 2 0 0 1 ) . T h e s e c o g n i t i v e d i s t o r t i o n s h a v e b e e n l i n k e d t o p a r e n t s

a t t r i b u t i n g h o s t i l e i n t e n t t o t h e i r c h i l d ' s b e h a v i o r , w h i c h i n t u r n h a s b e e n

l i n k e d w i t h o v e r r e a c ti v e a n d c o e r c i v e p a r e n t i n g ( B u g e n t a l , 2 0 0 0 ); a n g r y f e e l i n g s

i n p a r e n t s ( S l ep O ' L e a r y , 1 9 9 8) ; c h i l d b e h a v i o r p r o b l e m s ( S l e p O ' L e a r y ,

1 9 9 8) ; a n d t h e u s e o f h a rs h p u n i s h m e n t (A z a r , 1 9 9 7) . M o r e o v e r , e x p e r i m e n -

t a l m a n i p u l a t i o n o f p a r e n t s ' a t t r i b u t i o n s h a s s h o w n t h a t a t t r i b u t i n g r e s p o n s i -

b i l i t y a n d i n t e n t t o c h i l d r e n f o r t h e i r m i s b e h a v i o r h a s a d i r e c t i n f l u e n c e o n

o v e r - r e a c t i v e p a r e n t i n g , p a r e n t a l a n g e r , a n d n e g a t i v e a f f e c t i n c h i l d r e n ( S l e p

O ' L e a r y , 1 9 9 8 ). H e n c e , f a m i l y i n te r v e n t i o n s w i t h m a l t re a t i n g p a re n t s m a y

b e e n h a n c e d t h r o u g h c o g n i t iv e - b e h a v i o r a l s t ra t e g ie s t h a t s p e c i fi c a ll y f o c u s o n

c h a n g i n g p a r e n t a l a t t r i b u t i o n s , b y i d e n t i f y i n g d y s f u n c t i o n a l i n t e r p r e t a t i o n s

a n d b y p r o v i d i n g a c t i v e s k i ll s t ra i n i n g t o h e l p t h e m c h a l l e n g e t h e s e i n te r p r e -

t a ti o n s ( S a n d e r s M c F a r l a n d , 2 0 0 0 ) .

P a r e n t a l a n g e r h a s b e e n a s s o c i a t e d w i t h p o o r p a r e n t a l a d j u s t m e n t , c h i l d

b e h a v i o r p r o b l e m s a n d a d j u s t m e n t d i ff i cu l ti e s ( R e n k , P h a r e s , E p p s , 1 9 9 9 ),

a n d t h e u s e o f p h y s i c a l p u n i s h m e n t a n d c o e r c i v e d i s c ip l in e s t ra t eg i e s ( T h o m p -

s o n e t a l ., 1 9 9 9) . W h e n c o m b i n e d w i t h a t e n d e n c y t o w a r d h o s t i l e a t tr i b u ti o n s ,

p a r e n t s ' d e f i c it s i n a n g e r c o n t r o l m a y i n c r e a s e t h e r i s k o f u s i n g p h y s i c a l p u n -

i s h m e n t t h a t i s e x c e s s i v e o r s e v e r e i n n a t u r e ( W h i t e m a n e t a l ., 1 9 8 7 ) . P a r e n t a l


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P RENT L TTRIBUTION RETR INING ND NGER M N GEMENT 517

con t ro l cond i t i on fo r severa l r easons . F i r s t , i t a l l owed the e f f ec t s o f spec i f i c

t a rge ting o f a t tr i bu tions and paren t a l an ger t o be j udg ed aga ins t a c red ib l e ,

empir ical ly suppor ted parent ing in tervent ion that i s widely used in ear ly in ter -

ven t ion , p r imary care , and ch i ld m en ta l hea l t h se rv i ces in Au s t r a l ia as a p re-

ven t ive ear ly in t e rven t ion . Seco nd , l oca l com m uni ty ch i ld hea l th se rv i ces tha t

use Tr ip l e P as a rou t ine p reven t ive i n t e rven t ion w i shed to de t e rmine wh ether

the i n t e rven t ion wou ld be appropr i a t e fo r f ami l i es where t here was a r i sk o f

ch i ld mal t r ea tmen t . Th i rd , p r io r r esearch has a l r eady demons t ra t ed t ha t t he

g r o u p f o r m o f B F I u s ed h e r e i s mo r e e f f ec ti v e t h an n o i n te r v en ti o n an d w a i t-

l i s t cont ro l cond i t ions wi th o the r populat ions (Zu br ick et a l. , in press) and o ther

s tud i es have es t ab l i shed the ind iv idua l ly adm in i s t e red var ian t s as mo re e f f ec-

t ive t han non in t e rven t ion con t ro l s (Sander s , M ark i e-D adds , Tu l ly , Bor ,

2 0 0 0 ) . Th e s t an d a r d p r o g r am o f f e r ed h as b een t h o r o u g h l y ev a l u a t ed w i th v a r -

ious popu la t i ons an d has p roven to be a pow er fu l i n te rven t ion w i th h igh c red -

ib i l i t y fo r nonmal t r ea t i ng paren t s where behav io r p rob l ems ex i s t wi th p re-

ado les cen t ch i ld ren (Sa nder s , 1999) .

A l t h o u g h s u ch a d ec i s i o n r a i s e s s o me me t h o d o l o g i ca l i s s u es , w e b e l i ev ed

i t wa s une th i ca l t o wi thho ld t r ea tm en t f rom fami l i es wh ere t here was a s i gn i f-

i can t r i sk o f ch i ld mal t r ea tmen t and a r ead i ly ava i l ab l e a l t e rna t ive , wh ich ,

t hough no t spec i f i ca l l y t es t ed wi th a ch i ld abuse popu la t i on , r ep resen t ed t he

bes t ava i l ab l e a l te rna t ive t r ea tmen t . T he a l t e rna t ive o f r andomiz ing f ami l i es

to usua l ch i ld p ro t ec t i on serv i ces w as no t f eas ib l e as no t a l l par t ic ipa t ing f am-

i l i es had r eached the t h resho ld fo r ch i ld abuse no t i f i ca t i on . Fur thermore ,

t hese con cerns a re mi t i ga t ed t o som e ex t en t by t he f ac t t ha t dys func t iona l pa t -

t e rns o f paren t -ch i ld i n t e rac t i on t end to be f a i r ly s t ab l e , par t i cu l a r ly wh ere

ch i ld ren exper i enc e s ign i f ican t condu ct p rob l em s in assoc i a t i on wi th paren t a l

adjustment d i f f icul t ies .

Th e g r o u p f o r ma t o f T r i p le P w as s e l ec ted a s a co s t -e f f ec t iv e m e t h o d o f

in t e rven t ion t ha t o f fe red paren t s a w ay o f r educ ing soc i a l iso l a t ion , i ncreas -

ing suppor t , and p rov ided add i t i ona l l earn ing exper i ences t h rough shar ing

in fo rmat ion and ideas and th rough model ing pos i t i ve behav io r s (Chalk

King , 1998) .

W e p r ed i c t ed t h a t co mp ar ed t o S B F I p a r en t s r ece i v i n g EB F I w o u l d s h o w

sign i fi can t ly g rea t e r im provem ent s across a var i e ty o f a reas o f ch i ld , paren t ,

an d f ami l y f u n c t i o n i n g co mp ar ed t o t h e S B F I co mp ar i s o n g r o u p . EB F I co n -

d i t i on wou ld be assoc i a t ed wi th g rea t e r r educ t ions i n paren t s ' nega t ive a t t r i -

bu t ions fo r ch i ld ren ' s behav io r , wou ld show a s ign i f i can t ly g rea t e r r educ t ion

in t he r i sk f ac to r s fo r ch i ld mal t r ea tmen t a t pos t i n t e rven t ion ( i . e . , paren t a l

express ion o f anger ; paren t a l maladap t ive cogn i t i ons ; and po t en t i a l fo r ch i ld

abuse ) , s i gn i fi can t improve m ent s a t pos t i n t e rven t ion on ob serve d and paren t -

r epor t ed i nd i ca to r s o f paren t a l ad jus tme n t , i nc lud ing s imi l a r ou t c om es fo r

observed and paren t - r epor t ed ch i ld nega t ive behav io r s and s ign i f i can t ly

g rea t e r l eve l s o f consumer sa t i s f ac t i on assoc i a t ed wi th t he EBFI cond i t i on a t

p o s t i n t e r v e n t i o n . W e p r e d i c t e d t h a t t h e s e o u t c o m e s w o u l d b e m a i n t a i n e d

a t 6 - m o n t h f o l l o w - u p a n d t h e r e w o u l d b e r e d u c e d l e v e l s o f s u b s e q u e n t


6/23

518 SANDERS ET AL

n o t i f i c a t i o n s fo r EB FI f am i l i e s co m p ared wi t h SB FI f am i l i e s a t 6 -m o n t h

fo l low-up and few er re lapses in the pos t in te rven t ion per iod .

ethod

Participants

Par t i c ipan ts we re 98 fami l ies wi th a ch i ld aged 2 to 7 years . Recru i tme n t o f

p a r ti c ip an ts fo r t h e i n t e rv en t i o n o ccu r red t h ro u g h t h e r e f e r r a l o f c l i en ts f ro m

F a m i li e s, Y o u th a n d C o m m u n i t y C a re Q u e e n s l a n d ( F Y C C Q ; t h e m a n d a t e d

ch i l d p ro t ec ti o n au t h o r i t y in t h e S t a t e o f Qu een s l an d ) , f am i l y d o c t o r s, co m -

m u n i t y ch i l d h ea l t h s e rv i ce s , an d f ro m s e l f -r e f e r ra l s fo l l o wi n g m ed i a o u t -

reach abou t the p ro jec t ( inc lud ing newspaper a r t i c les and rad io in te rv iews) .

Th e o u t r each s t r a t eg y s p ec if i ca ll y t a rg e t ed p a ren t s w h o we re co n ce rn ed ab o u t

t h e ir an g e r o r t h a t t h ey w o u l d h a rm t h e ir ch i l d r a t h e r th an co n ce rn s s p ec if i-

ca l ly abou t ch i ld behav io ra l p rob lems .

Paren ts had to m ee t the fo l lowing se lec t ion c r it e r ia : (a ) paren t had rece ive d

a t l eas t one no t i f i ca t ion to the FYC CQ for po ten t ia l abuse o r neg le c t o f the i r

ch i ld ren ( the case need no t be subs tan t ia ted ) ; and /o r (b ) paren t expressed

conc erns regard ing d i f f i cu l ty in con t ro l l ing the i r ang er in re la t ion to the i r

ch i ld ' s behav io r , and scored wi th in an e leva ted range on th ree se lec ted sub-

sca les o f the S ta te -Tra i t Anger Express ion Inven to ry (STAXI; Sp ie lberger ,

1 99 6) ; A n g e r E x p re s s i o n ( i n d i ca ti o n o f t h e f r eq u en cy o f ex p re s s ed an g e r ) ;

T ra i t A n g e r ( th e t en d en cy t o ex p re s s an g e r w i t h o u t p ro v o ca ti o n ) ; an d An g e r -

Ou t ( th e f r eq u en cy o f an g e r ex p re s s ed t o ward o t h e r s o r o b j ec t s in t h e en v i-

ronm ent ) . Fami l ies tha t we re , a t t ime o f sc reen ing , rece iv ing in tens ive ongo ing

fam i l y t h e rap y o r p s y ch o t h e rap eu t i c i n te rv en t io n t a rg e ti n g p a ren t i n g o r ch i l d

b eh av i o r we re ex c l u d ed f ro m p a r t i c ip a t io n , a s w e re f am i l i e s wh o h ad a ch i l d

or paren t wi th a s ign i f ican t in te l l ec tua l impai rmen t . No fami l ies had to be

exc luded on these g rounds . Fam i l ies w ho d id no t m eet e l ig ib i li ty c r i t e ria were

re fe r r ed wh en ap p ro p ri a te t o o t h e r s e rv ice s i n t h e co m m u n i t y .

Pa r t ic i p a ti n g p a ren t s we re p red o m i n an t l y f em a l e an d m ar r i ed w i t h a t l e a s t

t wo ch i ld ren . Th e p a r t i c i p an ts ' m ean ag e w as 3 4 y ea r s . Ap p ro x i m a t e l y h a l f

o f t h e s am p l e o f p a rt ic i p an ts h ad co m p l e t ed th e i r s eco n d a ry ed u ca t i o n . Th e

m ean ag e o f ch i l d ren s e l ec t ed as t h e t a rg e t fo r i n t e rv en t i o n was 4 . 4 y ea r s ,

wi th equa l rep resen ta t ion o f m ale and fem ales ( see Tab les 1 and 2 ).

Measures

Fami ly background in terv iew

Fami l ies meet ing inc lus ion c r i t e r ia under-

wen t a s em i s t ru c t u red s t an d a rd i zed i n t e rv i ew (San d e r s , M ark i e -Dad d s ,

Turner , 2000) tha t e l i c i t ed in fo rmat ion abou t the i r p resen t ing p rob lems and

concerns abou t the i r ch i ld ' s behav io r ; charac te r i s t i cs o f persona l and fami ly

situat ions (e .g . , level o f edu cat ion, f inancial d i ff icul ties , h is tory of i l lness , dru g

use , and c r im ina l ac t iv ity ) ; and charac te r i s t i cs o f fam i ly o f o r ig in (e .g . , p sy -

ch ia t r i c i llness , d rug u se , fam i ly v io lence , and d i sc ip l ine s ty les ).

Observation o f child behavior

Chi ld d i s rup t ive behav io r was assessed us ing


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TABLE 1

DEMOGRAPHIC CHARACTERISTICSOF SAMPLES (DESCRIPTIVES)

519

SBFI (n = 48) EBFI (n = 50)

Variable

M SD M SD

Child's age (months) 53.71 19.32 52.84 17.85

Mother's age (years) 33.29 5.35 33.68 5.58

Father's age (years) 35.32 6.34 36.45 7.14

Age of participating parent (years) 33.33 5.37 34.18 6.34

Number of children in family 1.92 0.87 2.38 1.31

Years together as a couple 7.78 3.93 9.38 4.91

Note SBFI= Standard group parent training; EBFI = Enhanced behavioralfamily intervention.

a 30-minu te video-re corded home obs ervation. The observati on was divided

into two 15-minut e tasks recorded consecut ively: (a)

Free play task:

The par-

ent and child were asked to rem ain in the same room and do as they would

normally do in that part of the house. Once an observation comme nced,

observers did not interact with families and placed themselv es in an unobtru-

sive position wit hin the home to reduce any reactivity effects; and (b) Parent

busy task: A research assistant discussed with the parent a number of issues

relating to the parents' participation in the program with the target child in

TABLE 2

DEMOGRAPHIC CHARACTERISTICSOF SAMPLES (CATEGORICALVARIABLES)

SBFI EBFI

Variable (%) (%)

Female parent participant

Married couple

Target child is female

Participant did not complete secondary education

Participant's primary occupation is home duties

Annual family income is less than $25,000 (AUD)

Family is experiencing financial difficulties

Contact with statutory authority for suspected abuse or neglect

Participant currently uses illicit drugs

Participant currently abuses alcohol (>40g/day)

Family of origin issues for participant

Psychiatric illness in family

Arguing between parents

Physical harm between parents

Participant received belting as discipline

Participant received harsh discipline often

92 94

73 66

52 48

44 60

58 55

25 31

34 25

4 6

6 6

6 0

71 66

53 68

11 29

45 50

19 22

Note SBFI = Standard group parent training; EBFI = Enhanced behavioral amily intervention.


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52 S A N D E R S E T A L

t h e r o o m. To p i c s o f d i s cu s s i o n i n c l u d ed cu r r en t co n ce r n s ab o u t t h e f ami l y

and goa l s fo r change .

O b s e r v a t i o n s e s s i o n s w e r e co d ed i n co n s ecu t i v e 1 0 - s eco n d t ime i n te r v a ls ,

u s i n g t h e R ev i s ed F am i l y O b s e r v a t io n S c h ed u l e ( F O S - R ; S an d e r s , W au g h ,

Tu l ly , H yn es , 1996) . The FO S con ta ins 12 ca t egor i es fo r ch i ld behav io r s

an d o b s e r v ed a f f ec t ( e .g . , n o n co mp l i an ce , ag g r e s s io n ) . Th e F O S - R can r e li -

ab ly d i scr imina t e be tween behav io ra l ly d i s tu rbed and nond i s tu rbed fami l i es ;

has show n re l i ab il i ty and d i scr iminan t va l id ity ; and i s sens i t ive t o t he e f fec t s

o f behav io ra l in t e rven t ions on ch i ld ren w i th beha v io r p rob lem s (Sanders

Chr i s t ensen , 1985 ; Sand ers , M ark ie-D adds , Tu l ly , e t a l. , 2000) .

Two t r a ined observer s coded the i n t e rac t ions . Each ra t e r coded a se l ec t ion

of in t e rac t ions f rom each o f t he t h ree assessm en t phases ( i. e ., p re - , pos t - , and

6-mo nth fo l low -up) . Al l coder s w ere b l ind to t he i n te rven t ion con d i t ions o f

par t i c ipan t s , s t age o f assessm en t , i n t e rac tions used fo r r e li ab i li t y check s , and

the spec i fi c hyp o thes es be ing t es ted . In t e r ra t e r ag reem en t was a ssesse d show-

ing a sat i sfa ctory level of rel iabi l i ty ( .73) .

Measures of Risk of Maltreatment

Parent's Attributions fo r Child's Behavior (PAC BM ; Pidgeon Sanders,

2002).

The PACBM assesses paren t s ' a t t r i bu t ions fo r ch i ld ren ' s behav io r .

Th e B l ame an d I n ten t io n a l it y s u b s ca l e w as em p l o y e d to a s s e s s p a r en ts ' t en -

denc ies t o a t t r i bu t e b l ame and rea l - in t en t t o t he i r ch i ld ren ' s ac t ions . Af t e r

read ing a wr i t t en scenar io paren t s were asked to imag ine the i r own ch i ld i n

the s i t ua t ion and to i nd i ca t e how s t rong ly they be l i ev ed tha t t he i r ch i ld 's

ac t ions wou ld r esu l t f rom d i f fe ren t causes (1 =

strongly disagree; 5 =

strongly agree).

Thi s s ubsca l e has an adequ ate i n t erna l c ons i s t ency re l i ab il i ty

~ = . 8 3 ) .

State-Trait An ger Expre ssion Inventory (STAXI; Spielberger, 1996).

T h e

S T A X I p ro v i d e s a c o n c i s e m e a s u r e o f th e e x p e r i e n c e a n d e x p r e s s io n o f

an g e r . Th e S TA X I co n t a i n s s i x s ca l e s an d t w o s u b s ca l e s ( S t a t e - A n g e r ,

T r a it -A n g e r , A n g r y T e m p e r a m e n t , A n g r y R e a c t i o n , A n g e r -I n , A n g e r - O u t ,

A n g e r C o n t r o l , an d A n g e r Ex p r e s s i o n ) . Th e m eas u r e h a s d emo n s t r a t ed s a t -

i s f ac t o r y p s y ch o me t r i c p r o p e r t i e s , w i t h t e s t - r e t e s t r e l i ab i l i t y r an g i n g f r o m

.58 to .75.

Parental An ger Inventor)/' (PAl; Ha nsen Sedlar, 1998).

Th e P A I a s s e s s e s

anger exp er i ence d by paren t s i n r esponse to ch i ld - re l a t ed s i t ua t ions . I t y i e lds

a p rob lem score and an in t ens i ty sco re (paren t asked to r a t e how m uch a s it u -

a t ion makes them fee l angry ) . The PAI has modera t e r e l i ab i l i t y fo r t he Prob-

lem and In tensi ty scales ( r = .84 and r = .91) , in ternal consis ten cy, and cor-

r e l a t e s mo d e r a t e l y w i t h o t h e r meas u r e s o f an g e r an d ch i l d b eh av i o r ( e . g . ,

Ey b e r g C h i l d B e h av i o r I n v en t o ry ) .

Child Abuse Potential Inventory (CAP1; Milner, 198 6).

Th e C A P I a s s e s s e s

the r espond en t ' s a t t it udes , f ee l ings , and be l i e f s abou t paren t ing and i s used to

p r o v i d e a mea s u r e o f h ig h - r is k b eh av i o r f o r ch il d ab u s e . Th e ab u s e s u b s ca l e

o f t h e C A P I w as u s ed t o a s s e s s t h e ex t en t o f p h y s i ca l ab u s e t o ch i l d r en .


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P R E N T L T T R IB U T I O N R E T R IN I N G N D N G E R M N G E M E N T 521

R e p o r t e d a c c u r a c y o f t h e C A P I in c l a s s i f y i n g a b u s i n g p a re n t s i s 8 0 t o 9 0

o f r e f e r re d c a s e s .

Parent Opinion Questionnaire (POQ ; Aza r Rohrbeck, 198 6).

A n 8 0 - i t e m

i n s t ru m e n t d e s i g n e d t o m e a s u r e p a r e n t s ' u n r e a l i st ic e x p e c t a t i o n s o f c h i l-

d r e n ' s b e h a v i o r , t h e P O Q c o n t a i n s s i x s u b s c a l e s : S e l f - C a r e ; F a m i l y R e s p o n -

s i b il it y a n d C a r e o f S i b li n g s ; H e l p a n d A f f e c t i o n t o P a r e n t s; L e a v i n g C h i l-

d r e n A l o n e ; P r o p e r B e h a v i o r a n d F e e li n g s ; a n d P u n i s h m e n t . T h e P O Q h a s

t e s t - r e t e s t r e l i a b i l i t y o f . 8 5 o n t h e t o t a l s c o r e a n d d i s t i n g u i s h e s b e t w e e n m a l -

t r e a t in g a n d n o n m a l t r e a t i n g p a r e n t s .

Parenting M easures

Parenting Scale (PS; Arnold, O'Leary, W olff, Acker, 199 3).

T h e P S m e a -

s u r e s t h r e e d y s f u n c t i o n a l d i s c i p l i n e s t y l e s i n p a r e n t s : l a x n e s s ( p e r m i s s i v e d i s -

c i p l i n e ) ; o v e r r e a c t i v i t y ( a u t h o r i t a r ia n d i s c i p l i n e , d i s p l a y s o f a n g e r , m e a n n e s s ,

a n d i r r it a b il it y ); a n d v e r b o s i t y ( o v e r l y l o n g r e p r i m a n d s o r r e li a n c e o n t a lk i n g ) .

T h e P S d e m o n s t r a t e s a d e q u a t e i n te r n a l c o n s i s t e n c y fo r t h e t o ta l sc o r e ( ~ = . 8 4 ),

L a x n e s s (o~ = . 8 3 ) , O v e r r e a c t i v i t y (o~ = . 8 2 ) , a n d Ve r b o s i t y (eL = . 6 3 ) s c a l e s ,

a n d h a s g o o d t e s t - r e te s t r e l ia b i l i t y ( r = . 8 4 , .8 3 , .8 2 , a n d . 7 9 , r e s p e c t i v e l y ) .

Parent Sense o f Com petence (PSOC ; Gibaud-Wallston W andersman,

1978). T h i s m e a s u r e a s s e s s es p a r en t a l f e e li n g s o f c o m p e t e n c e a c r o ss t w o

d i m e n s i o n s : s a t i s f a c t io n w i t h th e i r p a r e n t a l r o l e a n d f e e l i n g s o f e f f i c a c y as a

p a r e n t . T h e t o t a l s c o r e , S a t i s f a c t i o n f a c t o r , a n d t h e E f f i c a c y f a c t o r s h o w a s a t -

i s f a c t o r y l e v e l o f i n t e r n a l c o n s i s t e n c y (e~ = . 7 9, . 7 5 , a n d . 7 6 , r e s p e c t i v e l y ) .

Parental Adjustment Measures

De pression-Anxiety-Stress Scales (DA SS; Lovibond Lovibond , 1995).

A s s e s s e s s y m p t o m s o f d e p r e s s i o n , a n x i e t y , a n d s t r e ss i n ad u l ts . I t c o n t a in s

h i g h i n t e r n a l c o n s i s t e n c y r e l i a b i l i t y f o r th e D e p r e s s i o n (oL = . 9 1 ) , A n x i e t y (c~ =

. 8 1 ) , a n d S t r e s s (oL = . 8 9 ) s c a l e s , a n d g o o d d i s c r i m i n a n t a n d c o n c u r r e n t v a l i d i ty .

Parent Pro blem Checklist (PP C ; D add s Powell, 1991).

T h e P P C r a t e s

p a r e n t s ' a b i l i t y t o c o o p e r a t e a n d w o r k t o g e t h e r i n f a m i l y m a n a g e m e n t . I t

e x p l o r e s t h e e x t e n t t o w h i c h p a r e n t s d i s a g r e e o v e r r u le s a n d d i s c i p li n e f o r

c h i l d m i s b e h a v i o r , t h e a m o u n t o f o p e n c o n f l i c t o v e r c h i ld - r e a ri n g i s s u e s , an d

t h e e x t e n t t o w h i c h p a r e n t s u n d e r m i n e e a c h o t h e r ' s r e l a t i o n s h i p w i t h t h e i r

c h i l d r e n . I t h a s m o d e r a t e l y h i g h i n t e r n a l c o n s i s t e n c y ( ~ = . 7 0 ) a n d h i g h te s t -

r e t e s t r e l i a b i l i t y ( r = . 9 0 ) .

M easures o f Child Behavior

Eyberg Child Behavior Inventory (ECBI; Eyberg Pincus, 199 9).

A m e a -

s u r e o f p a r e n t a l p e r c e p t i o n s o f d is r u p t i v e b e h a v i o r i n c h i l d re n a g e d 2 t o 1 6

y e a r s , i n c lu d i n g a m e a s u r e o f in t e n si ty o f b e h a v i o r a n d t h e n u m b e r o f b e h a v -

i o rs th a t a r e a p r o b l e m f o r p a r e n t s , t h e E C B I h a s h i g h i n te r n a l c o n s i s t e n c y

f o r b o t h t h e I n t e n s i t y ( r = . 95 ) a n d P r o b l e m ( r = . 94 ) s c a l e s a n d g o o d te s t -

r e t e s t r e l i a b i li t y .

Parent Da ily Rep ort Checklist (PDR C; Chamberlain Reid, 1987).

T h e


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522 SANDERS ET AL

P D R C i s a ch eck l i st o f 4 5 p r o b l em ch i l d b eh av i o r s u s ed a s a h o me mo n i t o r -

i n g f o r m w h er e p a r en t s r eco r d w h e t h e r t h e b eh av i o r s o ccu r each d ay o v e r a

7 - d ay p e r i o d . Tw o s co r e s a r e g en e r a ted : t h e To t a l B eh a v i o r s co r e ( s u m o f a l l

o c c u r r e n c e s o f p r o b l e m b e h a v i o r s ) a n d t h e T a rg e t B e h a v i o r s c o r e ( s u m o f

all behaviors ident i f ied by pa rents as problem at ic) . The target behav ior score in

part icula r show s strong interpa rent rel iabi l i ty (r = .89) and val idi ty (r = .48).

M easures o f Parent ing Contexts fo r Ch i ld Beha vior Problem s

Hom e and Com muni ty Prob lem Check l is t (HCP C; Sanders Dadds ,

1993). The H CP C i s a 29 - i tem check l i s t o f 15 spec i fi c s i tua t ions in t he hom e

(e.g . , bedt ime, get t ing dressed) and 14 s i tuat ions in the communi ty (e .g . , v i s i t -

ing f r iends or relat ives , going shopping) in which the parents exper ience d i f f i -

cu l ty in m anag ing the ir ch i ld s behav io r. The me asure der ived f rom the sca l e

used in t he p resen t s tudy was the t o t a l number o f p rob lem se t t i ngs t he paren t

repor ted thei r chi ld to be d i f f icul t . The measure has adequate in ternal consis-

tenc y (o~ = .91) and i s change sensi t ive to the ef fec ts of parent ing in tervent ions.

C lient Satisfac tion Questionnaire (CSQ). The ques t ionnai re eva lua t es t he

q u a l i ty o f s e r v i ce p r o v i d ed b y t h e p r o g r am, t h e m ee t i n g o f f ami l y n eed s , an d

a l lo w s p a r en ts t o co m m en t o n an y a s p e c t o f th e p r o g r am. Th e C S Q h as h ig h

internal c ons is ten cy (eL - - .96) , an i tem to tal correlat ion o f .66 and in ter - i tem

cor re l a t ions o f .30 to .87 (Sanders , M ark ie-D adds , T u l ly , e t a l ., 2000) .

Des ign

A 2 × 3 r ep ea t ed - meas u r e s r an d o mi zed g r o u p co mp a r i s o n d es i g n w as

employed . Exper imen ta l f ac to r s were two d i f f e ren t i n t e rven t ion cond i t i ons :

an enhanced g roup behav io ra l f ami ly i n t e rven t ion (EBFI ) ver sus a s t andard

group behav io ra l f ami ly i n t e rven t ion (SBFI ) . Fami l i es were assessed a t t h ree

t ime per iods : p re in t e rven t ion , pos t in t e rven t ion , and 6 -month fo l low-up .

Procedure

Immedia t e ly fo l lowing screen ing , and p r io r t o r andomiza t ion , f ami l i es

com ple t ed a se t o f paren t - repor t m easures ; a 90 -m inu te sem is t ruc tu red in t e r-

v i ew; and a hom e observa t ion o f paren t -ch i ld i n t e rac t ion . Fami l i es com ple t ed

p a r en t - r ep o r t meas u r e s an d p a r t i c i p a t ed i n a h o me o b s e r v a t i o n i mmed i a t e l y

fo l lowing t r ea tmen t c essa t ion and a t 6 -month fo l low-up . A b r i e f s t andard i zed

in t e rv i ew was a l so conducted a t fo l low-up to r e -assess t he f ami ly s i t ua t ion ,

e l i c i t i ng in fo rmat ion abou t r ecen t ch i ld behav io r , con tac t wi th t he Queens-

l an d D ep a r t men t o f F am i li e s an d C o mm u n i t y C a r e , co n t ac t w i t h med i ca l an d

hea l th p rac t i ti oner s , sc hoo l behav io r , and pare n t hea l th i s sues .

Intervent ion Condi t ions

SBFI . F ami l i e s a s s i g n ed t o t h e S B F 1 i n t e r v en t i o n r ece i v ed f o u r g r o u p

s es s i o n s o f p a r en t t ra i n in g ( 2 h o u r s d u r a t i o n each ) . U p o n co m p l e t i o n o f

t h e g r o u p s e s s i o n s , p a r en t s p a r t ic i p a t ed i n f o u r i n d i v id u a l t e l ep h o n e co n s u l -

t a ti o n s ( 1 5 t o 3 0 m i n u t e s d u r a t i o n each ) . P a r en t s a l s o r ece i v e d a co p y o f


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5 3

Every Parent s Group Workbook (M ark ie-D adds , Turner , Sande rs , 1997),

wh i ch co n t a i n s t h e k ey l ea rn i n g p r in c i p le s o f t h e p ro g ram an d ex e rc i s e s to b e

co m p l e t ed in an d b e t w een s e s si o n s. Th e p ro g ram i n v o lv ed teach i n g p a ren ts

17 core c h i ld -m anage m ent s trateg ies. Ten o f the s t ra teg ies a re des igne d to p ro -

m o t e ch i l d ren ' s c o m p e t en ce an d d ev e l o p m en t ( e .g . , p r a is e ; en g ag i n g ac ti v i-

t i es; inc iden ta l teach in g) and 7 s t ra teg ies a re des ign ed to he lp paren t s m anag e

m isbeha v io r (e .g ., se t ting ru les ; log ica l conse quen ces ; qu ie t time; t im e-ou t ) .

In add i t ion , paren t s were t augh t a p lanned ac t iv i t i es rou t ine to enhance the

genera l iza t ion and m ain ten anc e o f paren t ing sk i ll s . P lan ned Act iv i t ies Tra in -

ing invo lved teach ing paren t s how to an t ic ipa te and p repare fo r h igh-r i sk

s it u a ti o n s - - fo r ex am p l e , wh e n ch i l d ren a re ti r ed o r b o r ed - - an d t o p l an ag e -

appropr ia te ac t iv i ti es fo r these s i tua tions a long the l ines descr ibed by Sande rs

an d D ad d s (1 9 82 ) . C o n s eq u en t l y , p a ren t s w e re t au g h t t o ap p l y p a ren t i n g

s k il ls t o a b ro ad r an g e o f ta rg e t b eh av i o r s i n b o t h h o m e an d co m m u n i t y s et -

t ings wi th the t a rge t ch i ld and a l l re levan t s ib lings . Paren t s l earned to se t an d

m o n i t o r g o a ls fo r b eh av i o r ch an g e an d t o en h an ce t h e i r sk i ll s i n o b s e rv i n g

t h e i r ch i ld ' s an d t h e i r o w n b eh av i o r. Ac t i v e t ra i n in g m e t h o d s s u ch a s m o d e l -

ing , rehearsa l , p rac t ice , feedback and goa l se t t ing wer e used to t each spec i f ic

p a ren t in g s k il ls t h ro u g h o u t t h e p ro g ram wi t h i n a s e l f -r eg u l a to ry f r am e wo rk

(as descr ibed by Sanders , 1999) . The SBFI in te rven t ion typ ica l ly t akes 8

w eek s t o co m p l e t e .

EBFI.

Th e EB F I co n s i s t ed o f t h e a fo rem en t i o n ed SB F I s t r a teg i es p lu s t h e

add i t ion o f four sess ions add ress ing r i sk fac to rs assoc ia ted wi th ch i ld abuse

and neg lec t . The fami l ies in th i s cond i t ion rece ived four g roup sess ions o f

paren t t ra in ing (2 hou rs ' du ra t ion each ) ; four sess ions t a rge ting the add i t iona l

r i sk fac to rs (2 hours ' du ra t ion each) ; and four subsequen t ind iv idua l t e le -

phon e consu l ta tions (15 to 30 m inu tes ' du ra t ion each) . As wi th the SB FI cond i -

t ion , paren t s rece ived a cop y o f the

Every Parent s Group Workbook

(Mark ie-

Da dds e t a l ., 1997). In ad d i t ion , paren t s rece ive d a wo rkbo ok tha t ou t lines the

pr inc ip les t augh t in the add i t iona l modules ( focus ing on a t t r ibu t ions and

a n g e r m a n a g e m e n t ) .

In these ad d i t iona l sess ions , paren t s wer e t augh t a var ie ty o f sk i ll s a iming

t o ch a l l en g e t h e b e l i e f s t h ey h o l d r eg a rd i n g t h e i r o wn b eh av i o r an d t h e

b eh av i o r o f t h e i r ch i l d , an d t o c h an g e an y n eg a t i v e p rac t ice s t h ey cu r r en t l y

use in l ine wi th these be l ie fs. Paren t s were a l so in t roduced to a var ie ty o f phys -

ica l , cogn i t ive , and p lann ing s t ra teg ies to manage the i r anger . As wi th the

s t an d a rd p a ren t t r a i n in g c o m p o n en t , t h e co n cep t o f p l an n in g ah ead i n h i g h -

r i sk s i tua t ions was addressed and paren ts deve loped the i r own cop ing p lans

fo r t h e s e ev en ts . Th e E B F I t y p i ca l l y t o o k 1 2 we ek s t o co m p l e t e .

Sess ion 1B (unders tand ing causes o f paren t behav io r ) p rov ided the f i r st o f

the ad junc t ive in te rven t ions examin ing nega t ive paren ta l a t t r ibu t ions . The

sess ion was des ign ed to he lp paren t s iden t i fy the e f fe c t o f nega t ive o r harsh

d isc ip l ine p rac t ices on c h i ld ren , to iden t i fy the causes o f the i r own nega t ive

b e h a v i o r t o w a r d t h e c h i ld , a n d h o w t o p r e v e n t a n g e r e s c a l a t i o n a n d n e g a -

t ive paren t ing p rac t ices th ro ugh ch a l leng ing and d i spu t ing i r ra tiona l though ts


12/23

524 SANDERS ET AL

and replacing them with more rational thoughts. Session 5 introduced parents

to the emotion of anger, its physical effects , and provided parents with a vari-

ety of techniques and strategies for becoming physically and mentally

relaxed. Session 6 introduced cognitive therapy as it applies to anger manage-

ment and included catching unhelpful thoughts, developing alternative coping

statements in arousing situations, and challenging thoughts that lead to aggres-

sive responses. Session 7 completed the anger management intervention by

providing a review of the previous anger management sessions, identifying

high-risk anger situations, and developing coping plans to manage anger in

these situations. As with the SBFI intervention, the program concluded with

the four individual telephone consultations with one of the group facilitators.

Treatm ent Integrity

Fourteen practitioners 12 female and 2 male) were trained and supervised

in the delivery of the interventions 1 clinical psychologist; 8 psychologists

completing postgraduate training in psychology; 2 psychologists; 2 social

workers; and 1 teacher). Practitioners were not aware of the intervention

groups to which families had been assigned prior to completion of the pre-

intervention assessment phase. Each group was allocated one facilitator and

one co-facilitator. Facilitators led the group through the majority of treat-

ment sessions, while the role of the co-facilitator was to check protocol

adherence, videotape each session, assist with group exercises and activities,

and lead selected sections of the treatment plan under the guidance of the

facilitator.

Detailed written protocols specifying the content of each session, in-session

exercises to complete, and homework tasks were developed for both the SBFI

and EBFI conditions. Analysis of protocol adherence checklists in each con-

dition occurred to ensure that practitioners covered all the content material

specified. Interrater reliability checks were conducted with a high level of

agreement between the coder and the practitioners on content covered in each

session r = .94, p = .001). As a further check on protocol adherence, a

research assistant viewed 15 randomly drawn videotapes of group sessions in

each condition and coded the presence or absence of curriculum content item

specified in the protocol for that condition. This revealed a high mean level of

adherence to the protocol steps specified in the manuals for each condition

EBFI, M -- 98.73,

SD

= 2.68; SBF1, M = 98.75,

SD

= 2.29).

esu l t s

Preliminary nalyses

To examine the comparability of the samples of families in each condition,

a series of Univariate Analysis of Variance ANOVA) was used on parent-

report and observational data. There were no significant differences between

conditions on any measure at pre-intervention, indicating that randomization

had produced two groups that were well matched prior to intervention on all


13/23

P RENT L TTRIBUTION RETR INING ND NGER M N GEMENT 525

key ou t come measures used to eva lua t e t he e f f ec t s o f i n t e rven t ion . Fur ther -

mo r e , t h e t w o s amp l e s s e l ec t ed w e r e w e l l ma t ch ed o n a l l d emo g r ap h i c an d

f ami l y b ack g r o u n d v a r iab l e s.

A t t r i t i o n

O f the 98 f ami l ies com m encing the tr ia l, 86 (88 ) com ple t ed t he ir respec-

t ive i n te rven tions . E igh t o f the f am i l ies t ha t d ropped ou t o f t he s tudy w ere f rom

the EB FI cond i t ion ; 4 o f t he f ami l i es we re f rom the SB FI cond it ion . Two (2 )

o f t he 86 comple t e r s were uncon tac t ab l e a t t he pos t i n t e rven t ion assessmen t ,

and a fu r ther 2 (2 ) f ami l i es we re uncon tac t ab l e a t 6 -month fo l l ow-up .

S t a t i s ti c a l A n a l y s e s

An alyses o f i n te rven t ion e f fec t s cons i s t ed o f 2 ( cond i ti on : SB FI vs . EBFI ) ×

3 ( t ime: p re in t e rven t ion , pos t i n t e rven t ion , and fo l l ow-up) r epea t ed measures

M A N O V A s . W h er e s i g n i f i can t o mn i b u s e f f ec t s o r i n t e r ac t i o n s w e r e f o u n d ,

s u b s eq u en t u n i v a ri a te r ep ea t ed m eas u r e s A N O V A s an d p a i rw i s e co m p ar i s o n s

w e r e u s ed t o l o ca t e t h e s o u r ce o f s i g n if ican t d i f f e r en ces b e t w e en co n d i t io n s

and across t ime. As we wi shed to examine t he ex t en t o f c l i n i ca l l y r e l i ab l e

i mp r o v e m en t o v e r ti me a s s o c i a t ed w i th each co n d i ti o n , ma i n e f f ec t s f o r t ime

w ere fo l l ow ed up ev en whe re i n t e rac t ion e f fec t s we re nons ign if i can t us ing t he

c l in ica l l y r e l iab l e chang e index as desc r ibed by Jacob son and Truax (1991) .

I n v i ew o f t h e l a rg e n u m b er o f s ta t is t ic a l co m p ar i s o n s co n d u c t ed , w e h av e

adop ted a con serva t ive a lpha l eve l o f .01 across a l l ana lyses t o con t ro l fo r t he

poten t ial inf lat ion o f Ty pe 1 er ror .

S h o r t T e r m I n t e r v e n t i o n E f f e c t s

I t w as h y p o t h es i zed t h a t , w h en co mp ar ed w i t h S B F I , t h e EB F I co n d i t i o n

w ould r esu l t i n s ign i f ican t impro vem ent s across a var i e ty o f a reas o f f ami ly

func t ion ing . These a reas i nc luded r i sk f ac to r s assoc i a t ed wi th ch i ld mal t r ea t -

men t (paren t a l b l ame and in t en t iona l a t t r i bu t ions and paren t a l un rea l i s t i c

expec t a t i ons , behav io r , and a f fec t ) ; paren t ing p rac t i ces , paren t a l ad jus tmen t

and ch i ld behav io r . F ind ings appea r i n Tab le 3 .

I n b o t h t h e S B F I an d EB F I t r ea tmen t co n d i t io n s , p a r en ts s h o w ed s i g ni fi -

can t impro vem ent s f rom pre in t e rven t ion t o pos t i n t e rven t ion across a l l o f the

indicators of r i sk potent ial for chi ld abuse (e .g . , g lobal anger and parental

expre ss ion o f anger , parental b lam e and in tent ional at t r ibut ions , parental unre-

al i st ic expectat ions and poten t ial for chi ld abuse ) . Fur therm ore, a t post in terven-

t ion fami l ies in the EBFI condi t ion showed s igni f icant addi t ional improve-

men t s compared to SBFI f ami l i es on paren t a l po t en t i a l fo r ch i ld abuse ( as

measured by the CAPI ) , paren t a l b l ame and in t en t iona l a t t r i bu t ions fo r ch i ld

av e r s i v e b eh av i o r ( a s meas u r ed b y t h e P A C B M ) an d p a r en t a l u n r ea l i s t i c

ex p ec t a t i o n s r eg a r d i n g ch i l d b eh av i o r ( a s meas u r ed b y t h e P O Q ) . N o g r o u p

d i f fe r en ces w e r e o b s e r v ed a t p o s t in t e r v en ti o n o n t h e me as u r e s o f p a r ent a l

and g loba l anger .

A cros s all mea sures of parent ing (e .g . , parent ing s ty le , parental sat i sfact ion ,


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5 8

SANDERS ET AL

and ef f i cacy) f ami l i es i n bo th con d i t i ons d i sp l ay ed s ign i fi can t im prove m ent s

f rom pre- t o pos t in t e rven t ion . There were no s ign i f i can t g roup o r i n t e rac t ion

e f f ec ts o n t h e s e mea s u r e s .

From pre- t o pos t in t e rven t ion paren t s i n bo th cond i t i ons showed a s ign i f i -

can t decre ase i n paren ta l d i s t r ess and paren ta l conf l i c t , bu t t here w ere no con -

d i t ion o r i n t e rac t ion e f fec t s .

O n a ll meas u r e s o f ch il d b eh av i o r ( EC B I , P D R , o b s e r v ed n eg a ti v e ch i ld

behavior, and ob serv ed posi t ive child beha vior) both group s display ed significant

imp rovem ent f rom pre- t o pos t in t e rven t ion ; how ever , no s ign i f ican t cond i t i on

or in t e rac t ion e f fec t s were o b ta ined .

Paren t s i n bo th g roups r epor t ed a s ign i f i can t decrease i n t he number o f

p a r en ti n g an d ch i l d ca r e s i tu a t io n s i n w h i ch t h ey ex p e r i en ced p r o b l em b eh av -

i o r b o t h i n t h e h o m e an d i n th e co m mu n i ty . Th e r e w e r e n o co n d i ti o n o r i nt er -

ac t ion e f fec t s .

I t w as h y p o t h es i zed t h a t EB F I p a r t ic i p an t s w o u l d d i s p l ay g r ea t er l ev e ls o f

sa t is fac tion w i th t he i n t e rven tion they rece ived . A un ivari a te A NO VA revea l ed

tha t par t i c ipan t s i n bo th the SBF I (M = 86 .87 ,

SD

= 1 7 .0 8 ) an d EB F I ( M =

89 .44 ,

SD

= 15 ,74) cond i t i ons r epor t ed s imi l a r ly h igh leve l s o f con sum er

s a t is f ac ti o n , F ( 1 , 7 7 ) = 0 .4 8 .

Long Term Intervention Effects

Find ings f rom the 6 -month fo l low-up appear i n Tab le 3 . The resu l t s i nd i -

ca t ed tha t f ami l i es i n bo th cond i t i ons main t a ined a l l observed pos t in t e rven-

t ion ga ins . In a dd i t ion to t h i s ou t co m e, s ign if i can t e f fec t s w ere fou nd on th ree

o u t c o m e m e a s u r e s .

A s ign i f i can t in t e rac t ion and a m ain e f fec t fo r time w ere ob serv ed fo r

paren ta l b l am e and in t en t iona l a t t ri bu t ions i n bo th am biguo us and in t en t iona l

s i t ua t ions (measured by the PACBM) and paren ta l un rea l i s t i c expec t a t ions

r eg a rd i n g ch i l d b eh av i o r ( m eas u r ed b y t h e P O Q ) . D e s p i t e th e r e b e i n g a s i g-

n i f i can t ly g rea t e r improvement made by the EBFI par t i c ipan t s a t pos t in t e r -

v en t io n o n t h e P O Q me as u r e , S B F I p a r ti c ip an t s h ad ca u g h t u p t o t h e ir EB F I

co u n t e r p a rt s s o t h at t h e r e w a s n o s i gn i fi can t d i f f e r en ce o b s e r v ed b e t w een t h e

cond i t i ons a t fo l low-up .

A ma i n e f f ec t f o r t i me w as o b s e r v ed f o r p a r en t s ' an g r y t emp e r amen t ( mea -

s u r ed b y t h e S TA X I ) . H e r e , t h e g en e r a l t r en d w as f o r EB F I p a r t i c i p an t s t o

co n t i n u e t o i mp r o v e f r o m p o s t i n t e r v en t i o n t o f o l l o w - u p co mp ar ed w i t h t h e

SB FI par ti c ipan t s . H ow ever , pa i r -wi se com par i sons und er t aken to i nspec t t h is

ma in e f fe c t we re nons ign i f ican t .

Clinically Reliable Change

Three separa t e c r i t e r i a were used to assess t he c l i n i ca l s ign i f i cance o f

ch an g e i n ch i l d ren ' s b eh av i o r : t h e R e l i ab le C h an g e I n d ex ( R C I : J aco b s o n &

Truax , 1991) , a 30 reduct ion in obse rved ch i ld d i s rup t ive beha v io r (Webs ter -

S t ra t t on , Ho l l i nswor th , & Kolpacof f , 1989) , and a no rmat ive compar i son

approach wh ich invo lved ca lcu l a t ing the p ropor t ion o f ch ild ren wh ose behav io r


17/23

PARENTAL ATTRIBUTION RETRAINING AND ANGER MANAGEMENT

TABLE 4

FREQUENCY AND PERCENTAGE OF CLINICALLY RELIABLE CHANGE FOR CHILDREN'S

PROBLEM BEHAVIORFROM PRE- TO POSTINTERVENTION

529

N ( ) for each condition Contrasts (X2)

SBFI EBFI SBFI vs EBFI

RCI > 1.96

ECBI 38.46 34.20

RCI > 1.96

PDR 39.47 54.84

30 reduction

Observed negative child behavior ( ) 44.19 54.28

Moved below clinical cutoff (< 131)

ECBI 75.00 59.26

Moved beyond clinical cutoff (


18/23

530

SANDERS ET AL.

TABLE 5

FREQUENCY AND PERCENTAGE OF CLINICALLY RELIABLE CHANGE FOR CHILDREN'S

PROBLEM BEHAVIORFROM PREINTERVENTION TO 6-MONTH FOLLOW-UP

N ( ) for each condit ion Contrasts (X2)

SBFI EBFI SBFI vs EBFI

RCI > 1.96

ECBI 33.3 37.0

RCI > 1.96

PDR 56.41 48.27

30 reduction

Observed child negat ive behavior ( ) 46.15 52.94

Moved beyond clinical cutoff

ECBI 57.00 72.00

Moved beyond clinical cutoff ( )

PDR 60.00 63.64

0.190

0.442

0.335

Note

SBFI = Standard group parent training; EBFI = Enhanced behavioral family interven-

tion; RCI = Reliable Change Index; ECBI = Eyberg Child Behavior Inventory; PDR =

Parent Daily Report Checklist.

exam ined w hether spec i f i c t a rge ting paren t a l a t tr i bu tions and ange r enhances

c l i n ica l ou t com es fo r e i t her paren t o r ch i ld i n paren t s a t r i sk o f ch i ld mal t r ea t -

men t b ecau s e o f s i g n i f i can t an g e r - man ag emen t p r o b l ems . I n g en e r a l , t h e

f indings at tes t to the cl in ical u t i l i ty of behav ioral fam i ly in tervent ion wi th th i s

popu la t i on . P aren t s par t i c ipa ti ng i n bo th var i an t s o f Tr ip l e P i n t e rven t ions

show ed s ign if ican t improvem ent s i n a w ide r ange o f ind i ces o f f ami ly func t ion -

ing , wi th f ami l i es r ece iv ing the enhanced ver s ion showing g rea t e r improve-

m en t on tw o key ind i ca to r s o f abuse po t en t i a l in t he shor t te rm.

P a r en ts i n b o t h S B F I an d EB F I co n d i ti o n s s h o w ed a red u c t i o n i n d y s f u n c -

t i ona l a t t r i bu t ions , wi th EBFI par t i c ipan t s showing a s ign i f i can t ly g rea t e r

reduct ion i n t he i r po t en t i a l fo r ch i ld abuse (CAPI sco res ) and unrea l i s t i c

ex p ec t a t io n s ( P O Q s co r e s) . H o w ev e r , o n m eas u r e s o f an g er ex p e r i en ce o r

express ion , paren t s i n bo th i n t e rven t ions showed s imi l a r r educ t ions . Bo th

S B F I an d EB F I p a r ti c ip an t s p e r f o r med eq u a l l y w e l l o n p a r en t an d ch i ld m ea -

s u r e s o f b eh av i o r an d ad j u s tmen t an d r ep o r t ed co m p ar ab l y h i g h l ev e l s o f

con sum er sa t i s f ac t ion w i th t he ir r espec t ive i n t e rven t ions .

Fam i l ies in both condi t ions m aintained al l t reatment gains at 6-mo nth fo l low -

up . EBFI par t i c ipan t s d id per fo rm s ign i f i can t ly be t t e r t han t he SBFI par t i c i -

p an ts o n o n e o u t co m e meas u r e , t h e P A C B M . EB F I p a r ti c ip an t s s h o w ed a s ig -

n i f ican t ly g rea t e r r educ t ion i n nega t ive a t t ri bu t ions t han paren t s i n SBF I . The

spec i f ic t a rge t ing o f paren t s a t t ri bu t ions w as succ ess fu l i n r educ ing p aren t s

t endenci es t o b l ame and a t t r i bu t e r ea l - i n t en t t o t he i r ch i ld ren bo th i n s i t ua-

t i ons t ha t were ambiguous wi th r espec t t o t he ch i ld mot ives and in s i t ua t i ons


19/23

P R E N T L T T R IB U T IO N R E T R I N I N G N D N G E R M N G E M E N T

53

where children's behavior was more apparently deliberate. This generalized

shift in both parenting situations toward more benign explanations of their

children's actions showed that the cognitive mechanism hypothesized to shift

in angry parents did indeed change in the predicted direction.

Only one family in the study received contact with any child protection

services for child maltreatment in the follow-up period.

Previous research into interventions for maltreating or at-risk families have

indicated that standard parenting interventions might not be enough to meet

the complex needs of these families. The results of the present study support

this assertion to some degree. Although the EBFI condition was associated

with significantly greater improvements on measures of negative parental

attribution compared with standard parent training, at postintervention SBFI

families had also improved significantly on many measures. The differences

between conditions on the attributional measure maintained from postinter-

vention to follow-up.

However, we failed to find superior longer-term benefits for children. It is

possible that both the standard and enhanced parenting interventions incorpo-

rated elements that shifted parental attributions, albeit with different degrees

of specificity. While the enhanced condition systematically trained parents to

modify negative attributions for their own and their child's negative behaviors

(training which was absent from the standard comparison condition), parents

in the standard condition may have had some incidental exposure to attribu-

tional training as well. For example, in a standard group Triple P, once a sup-

portive environment is established within-group socialization processes may

lead parents to prompt and reinforce each other for generating constructive

alternative explanations for a child's actions (e.g., escalation traps) and attri-

butions of blame or mal-intent are not modeled or reinforced by group leaders.

Over time parents may be incidentally shaped by the group process to report

fewer destructive blame-oriented attributions and to focus more positively on

actions the parent can take to prevent problem behaviors.

The present study extends the limited empirical base of BFI as an interven-

tion for child maltreatment (James, 1994b; Wekerle Wolfe, 1993) by show-

ing that the two variants of BFI were both associated with a range of positive

changes in parental risk factors linked to child maltreatment. The main find-

ing that the enhanced Triple P intervention produced more consistent changes

across the full range of child measures, parent's cognitive, affective, and

parenting measures and family outcome variables was encouraging. How-

ever, these additional effects need to be interpreted with some caution as our

decision not to use a no-treatment control condition reduced our capacity to

rule out maturational effects or regression to the mean as an explanation of

improvements. On the other hand, using a high-strength, standard-care com-

parison condition was a strength. Our rationale in using such a comparison

condition was to provide a fairly tough test of the additive benefits of the

enhanced intervention. Further, we believed it was necessary to use an exist-

ing empirically supported comparison condition and to deliver it as close as


20/23

53

SANDERS ET AL

poss ib l e t o how i t i s de l i vered i n hea l th se rv i ces i n t he communi ty . Th i s

s eemed a b e t t e r ap p r o ach t o t e s t i n g t h e h y p o t h es i zed b en e f i t s o f en h an ce -

men t s t o ex i s t i ng BFI i n t e rven t ion s t r a t eg i es . Fur thermore , t o wi thho ld t r ea t -

men t f rom an a t - r i sk -o f -abuse sample i s e th i ca l l y ques t i onab le . A s imi l a r

s t r a tegy w as use d in o ther s t ud i es t es t ing ad junc t ive t r ea tmen t s fo r c l i n ica l l y

depressed paren t s ( e .g . , Sander s & McFar l and , 2000) . I t i s poss ib l e t ha t t he

en h an ced i n te r v en ti o n m i g h t b e ev en m o r e e f f ec t i v e w i t h n o n r e s p o n d e r s a f t e r

an in i t ia l t r ia l of a s tandard parent t rain ing in tervent ion.

Th e r e s u lt s o f t h e p r e s en t s t u d y n eed t o b e i n t e rp r e t ed w i th s o m e cau t io n .

Al thou gh a l l par t ic ipa t ing f ami l i es w ere ass essed t o be a t r i sk o f ch i ld m al -

t rea t men t o n t h e b a si s o f an g e r - man ag em en t co n ce r n s an d co e r c i v e p a r en ti n g

p r ac ti ce s , th e m a j o r i ty o f t h e s am p l e h ad n o t b een f o r ma l l y n o t i fi ed f o r ch il d

mal t r ea tmen t . Al though fo rmal no t i f i ca t i on t o ch i ld p ro t ec t i ve se rv i ces i s a

very c rude i ndex o f abus ive paren t ing , t he na tu re o f ou r r ecru i tmen t s t r a t egy

means t he p resen t r esu l t s canno t be s imply genera l i zed t o abuse popu la t i ons

recru i t ed t h rough o ther means ( e .g . , c l i n i ca l r e fe r ra l f rom ch i ld p ro t ec t i on

agenci es ) . Never the l ess , as a p reven t ive s t r a t egy fo r h igh- r i sk paren t s , t he

f ind ings a re mo re d i r ec t ly r e levan t . Fur thermo re , w i th in t he mul t i l eve l sys t em

of paren ting and f am i ly suppor t se rv i ces advo ca t ed i n the Tr ip l e P popu la t i on

model , ac t i ve ou t reach to t he communi ty i s seen as essen t i a l t o no rmal i z ing

par t i c ipa t i on i n paren t ing p rograms . Each f ami ly r ece ived ind iv idua l t e l e -

phone consu l t a t i ons a f t e r par t i c ipa t i ng i n g roups . Whi l e such an approach i s

r ead i ly accep ted by paren t s and a l l ows fo r t a i l o r ing o f sess ion con ten t , fo r

fami l i es wi thou t access t o t e lephon es ( a smal l minor i t y o f peo p le i n Aus t r a -

l i a ) , t hese t e l ephone consu l t a t i ons cou ld be conducted as f ace- to - face i n t e r -

v i ew s e it her a t hom e o r i n a c l i n ic sess ion . Al so , t he am oun t o f t herap i s t con-

t ac t necessar i l y d i f f e red across t he two cond i t i ons , i n t roducing a po t en t i a l

confou nd ; t ha t i s , t he EB F had four ex t r a sess ions o f t herap i s t con t ac t . H ow -

ever , i t i s no t poss ib l e t o add ad junc t ive i n t e rven t ions wi thou t i ncreas ing

e i ther sess ion l eng th o r t he number o f sess ions . We chose no t t o a r t i f i c i a l l y

ex t end the am oun t o f paren t ing sk i ll s tr a in ing in the SB FI cond i t i on t o match

the am oun t o f ex t ra t herap i s t con t ac t in t he EB FI con d i t i on as th i s wo u ld have

in t roduced ano ther confound , namely , d i f f e r ing amoun t s o f t ime devo ted t o

basic parent ing ski l l s t rain ing.

The p resen t f i nd ings have severa l impl i ca t i ons fo r ear ly - in t e rven t ion p ro -

g rams fo r f ami l i es a t r i sk o f ch i ld mal t r ea tmen t . Rather t han t ry ing to des ign

m ore com plex paren t ing i n t e rven t ions address ing paren t a l a t t r ibu t ions and

anger management , f ami l i es can be p rov ided wi th a l ess i n t ens ive i n t e rven-

t i on i n t he f ir s t i n s t ance ( e .g ., t he S BF I i n t e rven t ion de l ivered t o f am i l ies i n

th is t r ia l ) . Dur ing th is in i tia l phase o f in tervent ion, p ar t icular a t tent ion nee ds

to be paid to engaging p arents and m aintain ing thei r involvem ent as such parents

h av e b een s h o w n t o b e a t i n c r ea s ed r is k o f d r o p p i n g o u t o f tr ea tmen t . S u b s e -

quen t t o f ami l i es r ece iv ing th is s t andard paren t ing i n t e rven t ion , r eass essm en t

cou ld occur to gauge any shi f t in the r isk factors for malt reatment (e .g . , coercive

paren t ing p rac t i ces , nega t ive a t t r i bu t ions , excess ive anger , and unreasonab le


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P AR ENTAL ATTR IB UTION R ETR AINING AN D A NGE R MANAGEMENT

5

expec ta t ions ) . Based on th i s a s se s sment , prac t i t i oners can ident i fy the r i sk

fac tors tha t are s t i l l ev ident and prov ide a cus tomized adjunc t ive in terven-

t i on s ) tha t spec i f i ca l l y target s the r i sk fac tor . Th i s c on c lu s ion i s cons i s t en t

wi th the f ind ings o f o ther t r ia l s eva lua t ing adjunc t ive in tervent ions combined

with ind iv idual ly adminis tered vers ion s of Triple P w ith parents of children w ith

c o n d u c t p r o b l e m s e . g . , S a n d e r s e t a l ., 2 0 0 0 ) .

eferences

Arnold , D. S . , O 'L eary , S . G. , Wolff , L . S . , Acker , M . M. (1993) . The Parenting Scale: A measure

of dysfunctional parenting in discipline situations.

PsychologicalAssessment,

5 , 137 -144 .

Au st ra l ian Ins t i tu te o f Hea l th and W elfa re . (2000) . Child pJvtection Australia: 1998-99. C a n-

berra: Author.

Azar , S . T . (1997). A cogni t ive behaviora l approach to unders tanding and t rea t ing pa rents w ho

physica l ly abuse the i r chi ldren . In D. A. W olfe , R . J . M cM ahon , R. DeV. Pe te rs (Eds .) ,

Child abuse: New directions in prevention and treatment across the lifespan

(pp . 79 -101) .

Thousa nd Oa ks , C A: S a ge P ub l i ca t ions .

Azar , S . T . , Ro hrbeck , C . A. (1986) . Ch i ld abuse and unrea l i s t ic expec ta t ions : Fur the r va l ida -

t ion of the Parent Opinion Ques t ionna i re .

Journal of Consulting and Clinical Psychology,

5 4 , 8 6 7 - 8 6 8 .

Barkley , R . A. , Edw ards , G. , Laner i , M. , F le tcher , K. , M etevia , L . (2001). Th e e ff icacy of

p rob l e m-so l v i ng c om muni c a t i on t r a i n ing a l one, be ha v i o r ma na ge m e n t t r a i n ing a l one , a nd

t he i r c ombi na t ion fo r pa re n t -a do l e sc e n t c on f l i ct in t e e na ge r s wi t h AD HD a nd O DD . Jour-

nal of Consulting and Clinical Psychology, 69,926-941.

Black, D. A. , Hey man , R. E. , S lep , A. M. (2001) . Risk factors for chi ld phys ica l abuse .

Aggression and Violent Behavior, 6, 121-188.

Brestan, E. V., Eyb erg, S. M . (1998). Effect ive psych osoc ial t reatments of condu ct-disordered

children and adolescents: 29 years, 82 studies, 5,272 kids.

Journal of Clinical Child Psy-

chology, 27, 1 8 0 - 1 8 9 .

Bug enta l , D. B. (2000). Pa renta l and chi ld cogni t ions in the context of the fami ly . Annual

Review o f Psychology, 51, 3 1 5 - 3 4 4 .

Ch alk, R. , K ing, R A. (Eds.). (1998).

Violence in families: Assessing prevention and treat-

ment programs.

W a sh i ng t on , DC : Na t i ona l Ac a d e my P re ss .

Cham berla in , R , Re id , J. B . (1987) . Pa rent obse rva t ion and repor t of chi ld symptom s. Behav-

ioral Assessment, 9, 9 7 - 1 0 9 .

Con ne l l , S . , Sanders , M. R. , Mark ie -Dadd s , C . (1997) . Se l f -d i rec ted behaviora l fami ly in te r-

vent ion fo r pa rents of op pos i t iona l chi ldren in rura l and rem ote a reas .

Behavior Modifica-

tion, 21,379-408.

Dadd s , M. R. , Pow el l , M. B. (1991) . The re la t ionship of in te rpa renta l conf l ic t and g loba l

mari ta l ad jus tment to aggress ion , anxie ty , and imm atur i ty in aggress ive nonc l in ic chi ldren .

Journal o f Abnormal Child Psychology, 19,553-567.

Egan , K. J . (1983). S tress man agem ent and chi ld ma nagem ent wi th abus ive pa rents .

Journal of

Clinical Child Psychology, 12,292-299.

Ey berg, S. M ., Pincus , D. (1999). Eyberg Child Behavior Inventory and Sutter-Eyberg Student

Behavior Inventory-Revised: Professional manual.

Ode ssa , F L : P syc ho l og i c a l Asse s sme n t

R e sourc e s .

Forehand , R. L. , M cM ahon , (1981) .

Helping the noncompliant child: A clinician s guide to

parent training.

New York: The G ui l ford Press .

Gibaud-W al l s ton , J . , Wan dersman, L. P . (1978) . Development and utility of the Parenting

Sense of Competence Scale.

P a pe r p re se n te d a t t he me e t i ng o f t he Ame r i c a n P syc ho l og i c a l

Assoc ia t ion , Toronto .


22/23

534 SANDERS ET AL.

Ha nse n, D. J . , Sedlar, G. (1998). Manual or the PAl: The PamntalAnger Inventory.L i n c o l n ,

N E : C S B F I R

Haug aard , J . J . , Repp ucci , N. D. , Feer ick , M. M. (1997). Ch i ldren ' s coping with mal t reat-

m ent. In S. A. Wolchik I . N. Sand ler (Eds.) , Handbook of children s coping: Linking theory

and intervention (pp. 73 -10 0) . New York: P lenu m Press.

Jacobson, N. S . , Truax, E (1991) . Cl in ica l s ignif icance: A s ta tist ical approach to def in ing

me anin gful change in psychop athology research. Journal of Consulting and Clinical Psy-

chology, 59, 1 2 - 1 9 .

James , M . (1994a) . C hi ld abuse and neglect : Incid ence and prevent ion. Issues in Child Abuse

Prevention (Numb er 1 ). M elbourne : Aus t r a l ian Ins t itu te o f Fam i ly S tud ies.

James , M . (1994b) . C hi ld abuse prevent ion: A perspect ive on parent enha nce me nt programs

from the U nited States . Issues in ChildAbuse Prevention (Numb er 3 ) . Melbou rne : Aus t r a -

l ian Ins t i tu te of Fam ily S tudies .

Kolko, D. J . (1996). Cl in ica l m onitor in g of t reatme nt course in chi ld phys ical abuse: Psych o-

metr ic character is tics and t reatm ent com par isons .

Child Abuse and Neglect, 20,

2 3 - 4 3 .

Lov ibond , S . H. , Lov ibond , R F . (1995). Manual for the Depression Anxiety Stress Scales

(2nd ed . ) . Sydney : P s ycho logy Foun da t ion o f Aus t r a li a .

M arkie-Dadds , C. , Sanders , M. R. (2002) . Effectiveness of a self-directed program for par-

ents of children at high and low risk of developing conduct disorder. U n p u b l i s h e d m a n u -

scrip t, Univ ers i ty of Q ueen s land, S t . Lucia .

M arkie-Dadd s , C. , Turner , K. M. T. , Sanders , M. R. (1997). Every parent s group workbook.

Br is bane : Fam i l i e s In te rna t iona l Pub l i sh ing .

M ilner, J . S. (1986). The Child Abuse Potential Inventory: Manual (2nd ed .) . DeKalb , IL:

Psytec Inc.

Nat io nal Research Cou nci l . (1993). Understanding child abuse and neglect. W as h ing ton , DC:

Nat iona l Aca dem y P ress .

P idge on, A. , Sande rs , M. R. (2002). Parent s Attributions of Child Behavior Measure.

Unpu b l i s hed manus cr ip t, The Un iver s i ty o f Q ueens land .

Ren k, K. , Phares, V. , Epps , J. (1999). The re la t ionship betw een parental anger and behav ior

p rob lems in ch i ld ren and ado les cen t s . Journal o f Family Psychology, 13,209-227.

Repu cci , N. D. , Br i tner , P . A. , W oolard , J . L. (1997). Preventing child abuse and neglect

through parent education. Balt imore: Paul H. Brooks .

Sander s , M. R . (1999). The Tr ip le P -Pos i t ive Paren t ing P rogram: Towards an em pi r i ca l ly va l -

ida ted mul t i l eve l pa ren t ing and f ami ly s uppor t s t ra tegy fo r the p reven t ion o f behav io r

and emot iona l p rob lems in ch i ld ren . Clinical Child and Family Psychology Review, 2,

7 1 - 9 0 .

Sanders , M. R. , Chr is tense n, A. R (1985). A com par ison of the ef fects of chi ld ma nag em ent

and planned act iv i t ies t ra in ing across f ive parent ing environments .

Journal of Abnormal

Child Psychology, 13, 1 0 1 - 1 1 7 .

Sanders , M. R. Dad ds , M. R. (1982). The effects of p lan ned act iv i t ies and chi ld ma nag em ent

procedures in p arent t ra in ing: An analys is of set t ing general i ty . Behavior Therapy, 13,

4 5 2 - 4 6 1 .

Sanders , M. R. , Dadds , M. R. (1993) . Behavioral family intervention. Needham Heigh t s ,

M A : A l l y n a n d B a c o n .

Sanders , M. R. , Ma rkie-Dadds , C. , Tul ly , L. , Bor , W. (2000). The Tr ip le P-Pos i t ive Parent ing

Program: A compar i s on o f enhanced , s t andard , and s e l f d i rec ted behav io ra l f ami ly in te r-

vent ion. Journal of Consulting and Clinical Psychology, 68,624-640.

Sande rs , M. R. , Ma rkie-Dadd s , C. , Turner , K. M. T. (2000) . Practitioner s manual for Stan-

dard Triple P.

Br is bane : Pa ren t ing and Fam i ly Suppor t Cen t r e .

Sande rs , M. R. , M cFar lan d, M. (2000). The treatm ent of depressed mothers with d is rupt ive

ch i ld ren : A com par i s on o f pa ren t t r a in ing and cogn i t ive behav io ra l f ami ly in te rven t ion .

Behavior Therapy, 31, 8 9 - 1 1 2 .


23/23

PARENTAL ATTRIBUTION RETRAINING AND ANGER MANAGEMENT 535

Sanders , M. R. , W augh, L. , Tul ly , L. , Hy nes , K. (1996).

The Revised Family Observation

Schedule

(3 rd ed . ). Br i s bane : Pa ren t ing and Fam i ly Suppor t Cen t r e , The Un iver s i ty o f

Queens land .

S i lve rman , A . B . , Re inberz , H . Z . , G iacon ia , R . M. (1996). Th e long- te rm seque lae o f ch i ld

and a dolescent abuse: A longi tu dinal com mu nity study. ChildAbuse and Neglect , 20, 7 0 9 -

723.

Slep , A. M. S . , O 'L eary , S . G. (1998) . The effects of maternal a t t r ibut ions on parent ing: An

exper imental analys is . Journal o f Family Psychology, 1 2,23 4-2 43.

Spielberger, C. D. (1996).

State-trait anger expression inventory professional manu al).

Lutz,

FL: Ps ycho log ica l As s es s men t Res ources.

S tern , S . B. , Azar , S . T. (1998) . In teg rat ing cogni t ive s tra tegies in to behavioral t reatme nt for

abus ive parents and fam il ies with aggressive adolescents . Clinical Child Psychology and

Psychiatry , 3 ,387-403.

Thom ps on , R . A . , C hr i s ti ans en , E . H . , J acks on , S . , Wyat t , J . M . , C o lman , R . A . , Pe te r s on , R . L . ,

W ilcox, B. L. , Buck endah l , C. W. (1999) . Parent a t ti tudes an d discip l ine pract ices: Pro-

f iles and correla tes in a nat ion al ly representat ive sample.

Child Mal treatment , 4 ,3 16 -33 0.

W ebster -Strat ton , C. (1990). En han cing the ef fectiveness of sel f -adm inis tered v ideotape parent

t r a in ing fo r f am i l ie s w i th conduc t -p rob lem ch i ld ren . Journal o f Abnormal Child Psychol-

ogy, 18 ,47 9-492 .

W ebster -Strat ton , C. , Hol l insw or th , T. , Kolpacoff , M. (1989) . The long- term effectiveness

and cl in ical s ignif icance of three cost-ef fective t ra in ing programs for fam il ies with con -

duc t -p rob lem ch i ld ren . Journal o f Consulting and Clinical Psychology, 57, 5 5 0 - 5 5 3 .

W eker le , C. , W olfe , D. A. (1993). Preve nt ion of chi ld phys ical abuse and neglect : Prom is ing

new direct ions .

Clinical Psychology Review, 13,501-540.

W eker le , C. , W olfe , D. A. (1996). Ch i ld ma l t reatment . In E. J . Ma sh R. A. BarN ey (Eds .) ,

Child psychopathology

(pp. 492- 53 7) . New York: The G uilford Press .

W hitem an, M., Fanshe l , D. , Grun dy, J . F . (1987). C ogni t ive-behav ioral in tervent ion s a im ed

at ang er of parents a t r isk of chi ld abuse. Social Work, 32 ,46 9-4 74.

Zub r ick , S . R. , Northey, K . , S i lburn , S . R. , W il l iams , A. A. , Blair , E. , Rober tson, D. , Sanders ,

M. R . ( in press ). Preve nt ion of chi ld behav iour problem s via universal imp lem entat ion of a

g roup behav iou ra l f am i ly in te rven t ion .Prevention Science.

RECEIVED: Janu ary 27 , 2003

ACCEPTED: Au gu st 14, 2003

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