Hitkashrut

Note: The Hitkashrut program was not responsive to the CEBC's inquiry. The following information was obtained from publicly available sources.

About This Program

Target Population: Families with children who are showing early signs of conduct problem development

Program Overview

Hitkashrut, which means "attachment" in Hebrew, is a theory-based, common elements co-parent training program that targets families with children who are showing early signs of conduct problem development. Using a family systems approach, this program aims to motivate children to shift from antisocial to prosocial attitudes by reshaping the parent-child relationship and improving collaboration among parents and between parents and teachers. This program targets callous/unemotional traits and low effortful control, which are indicators of a developmental trajectory toward antisocial or disruptive behaviors. The program involves 14 group sessions facilitated by psychologists that include psychoeducational instruction, group discussions, role plays, and homework assignments. The program's six components are:

  • Interaction quality/time
  • Parent-child communication skills
  • Behavior management
  • Discipline skills
  • Parent self-regulation capacity
  • Couple communication skills

Hitkashrut uses a collaborative model in which both caregivers and teachers are involved in behavior management. This program was designed to be cost-efficient for use with diverse communities. While it is manual-based, it attempts to maximize flexibility and cultural adaptability.

Education and Training

Education and Training Resources

Publicly available information indicates there is a manual that describes how to implement this program, and there is some training available for this program.
See contact info below.

Relevant Published, Peer-Reviewed Research

This program is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The program must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. The article(s) below that reports outcomes from an RCT showing a sustained effect of at least 6 months has an asterisk (*) at the beginning of its entry. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

*Somech, L. Y., & Elizur, Y. (2012). Promoting self-regulation and cooperation in pre-Kindergarten children with conduct problems: A randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 51(4), 412-422. doi:10.1016/j.jaac.2012.01.019

Type of Study: Randomized controlled trial
Number of Participants: 209 families

Population:

  • Age — Children: 32-64 months (approximately 2.67-5.33 years), Parents: 21-62 years
  • Race/Ethnicity — Children: Not specified, Parents: 78% Israeli, 7.7% European, 5.6% North American, 3.9% South American, and 4.8% African
  • Gender — Children: 163 Males and 46 Females, Parents: Not specified
  • Status — Participants were families with children referred by pre-K teachers who were at risk for conduct problems.

Location/Institution: Jerusalem

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluates the effectiveness and mechanisms of the Hitkashrut program for early intervention with preschoolers at risk for conduct problems (CP). Participants were assigned to 14-session Hitkashrut co-parent training groups (n=140 couples) or to minimal intervention control groups with referral to local services as necessary (n=69 couples). Measures utilized include the Strengths and Difficulties Questionnaire (SDQ), the Eyberg Child Behavior Inventory (ECBI), Effortful Control (EC), the Callous/Unemotional traits (CU), the Parental Stress Index-Short Form, the Marital Quality Scale (MQS-I), and the Alabama Parenting Questionnaire – Preschool, Revised. Results indicate at both follow-ups that parents in the Hitkashrut group reported clinically significant improvement in conduct problems, callous unemotional traits and effortful control as compared to the control group. Limitations include high attrition at follow-up for control group and reliance on self-reported measures.

Length of postintervention follow-up: 1 month and 1 year.

Elizur, Y., Somech, L. Y., & Vinokur, A. D. (2017). Effects of parent training on callous-unemotional traits, effortful control, and conduct problems: Mediation by parenting. Journal of Abnormal Child Psychology, 45(1), 15-26. doi:10.1007/s10802-016-0163-7

Type of Study: Randomized control trial (secondary data analysis)
Number of Participants: 209 families

Population:

  • Age — Children: 32-64 months (approximately 2.67-5.33 years), Parents: 21-62 years
  • Race/Ethnicity — Children: Not specified, Parents: 78% Israeli, 7.7% European, 5.6% North American, 3.9% South American, and 4.8% African
  • Gender — Children: 163 Males and 46 Females, Parents: Not specified
  • Status — Participants were families with children referred by pre-K teachers who were at risk for conduct problems.

Location/Institution: Jerusalem

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study utilized data from Somech & Elizur (2012) to evaluate the effectiveness and mechanisms of the Hitkashrut program for early intervention with preschoolers at risk for conduct problems. Participants were assigned to 14-session Hitkashrut co-parent training groups (n=140 couples), or to minimal intervention control groups with referral to local services as necessary (n=69 couples). Measures utilized include the Strengths and Difficulties Questionnaire (SDQ), the Eyberg Child Behavior Inventory (ECBI), Effortful Control (EC), the Callous/Unemotional Traits (CU), the Parental Stress Index-Short Form, the Marital Quality Scale (MQS-I), and the Alabama Parenting Questionnaire – Preschool, Revised. Results for the Hitkashrut group indicate significant concurrent treatment effects on conduct problems and on either CU traits or EC between 1-month and 1-year follow-up. Treatment effects on CU traits, EC, and conduct problems were mediated by ineffective parenting. Limitations include high attrition at follow-up for control group and reliance on self-reported measures.

Length of postintervention follow-up: 1 month and 1 year.

Elizur, Y., & Somech, L. Y. (2018). Callous-unemotional traits and effortful control mediate the effect of parenting intervention on preschool conduct problems. Journal of Abnormal Child Psychology, 46(8), 1631-1642. doi:10.1007/s10802-018-0412-z

Type of Study: Randomized control trial (secondary data analysis)
Number of Participants: 209 families

Population:

  • Age — Children: 32-64 months (approximately 2.67-5.33 years), Parents: 21-62 years
  • Race/Ethnicity — Children: Not specified, Parents: 78% Israeli, 7.7% European, 5.6% North American, 3.9% South American, and 4.8% African
  • Gender — Children: 163 Males and 46 Females, Parents: Not specified
  • Status — Participants were families with children who were at risk for conduct problems and referred by pre-K teachers.

Location/Institution: Jerusalem

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study utilized data from Somech & Elizur (2012) to test posttreatment callous-unemotional (CU) traits and effortful control (EC) mediation of treatment effect on 1-year follow-up conduct problems (CP) of the Hitkashrut program and to determine whether mediation by each child-level potential mediator remains significant when tested concurrently with the parenting mediator. Participants were assigned to 14-session Hitkashrut co-parent training groups (n=140 couples), or to minimal intervention control groups with referral to local services as necessary (n=69 couples). Measures utilized include the Strengths and Difficulties Questionnaire (SDQ), the Eyberg Child Behavior Inventory (ECBI), Effortful Control (EC), the Callous/Unemotional Traits (CU), the Parental Stress Index-Short Form, the Marital Quality Scale (MQS-I), and the Alabama Parenting Questionnaire – Preschool, Revised. Results for the Hitkashrut group indicate an intent-to-treat analysis showed that EC and CU traits simultaneously mediated treatment effects on CP in one EC/CU mediational model. The concurrent testing of child- and parent-level mediators showed mediation by IP and CU traits in the CU/IP model, and IP mediation in the EC/IP model. Similar results were obtained in mediational analyses that controlled for the shared variance between the mediators and CP at T2. Limitations include that mediational analysis may suggest a mechanism of change but does not prove causality, the reliance on self-reported measures, the lack of scales or observational data to assess fidelity, and concerns about generalizability to other ethnic groups due to the all-Jewish sample.

Length of postintervention follow-up: 1 year.

Additional References

Elizur, Y. (2016). Tommy Turtle's brainpower: Promoting children's social and emotional competence. CreateSpace Independent Publishing Platform.

Contact Information

Yoel Elizur
Email:

Date Research Evidence Last Reviewed by CEBC: March 2018

Date Program Content Last Reviewed by Program Staff: March 2018

Date Program Originally Loaded onto CEBC: August 2016