Parenting through Change (PTC)

Scientific Rating:
1

(provisional rating)

Well-Supported by Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium

(provisional rating)

See descriptions of 3 levels

Provisional Rating

Parenting through Change (PTC) currently has a provisional rating for the 60 days between: October 23, 2017 and December 22, 2017. If you would like to respond to the Scientific Rating, please submit feedback via the Contact Us page.

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Parenting through Change (PTC) has been rated by the CEBC in the area of: Parent Training Programs that Address Behavior Problems in Children and Adolescents.

Target Population: Parents of children ages 2-18 at risk for or presenting with behavior problems

For parents/caregivers of children ages: 2 – 18

Brief Description

PTC is a group parenting intervention that addresses child and adolescent behavior problems, including oppositional defiant and conduct problems and associated challenges such as attention-deficit hyperactivity disorder (ADHD) symptoms, delinquency, substance use, depression, academic problems, and deviant peer association. Weekly parent group sessions introduce a set of core parenting practices (e.g., skill encouragement, limit setting, monitoring, problem solving, and positive involvement) and supporting practices (e.g., active communication, emotion regulation, and academic promotion). Group facilitators use active teaching skills (e.g., role play and problem solving) to introduce and practice skills. Parent groups, which are designed for prevention and clinically referred samples, are available in 10, 12, and 14 session formats. The individual family session version of this intervention, Parent Management Training – Oregon Model (PMTO®) is also rated on the CEBC.

Program Goals:

The overall goals of Parenting Through Change (PTC) are:

  • Strengthen effective parenting practices
  • Reduce coercive family processes
  • Specific targets include the following:
    • Strengthen collaborative parenting
    • Enhance parental mental health
    • Prevent out-of-home placement
    • Reduce and prevent child/youth behavior problems (e.g., aggression, externalizing behavior, internalizing behavior, delinquency, drug use/abuse, deviant peer association)
    • Strengthen youngsters’ academic functioning
    • Increase youngsters’ prosocial skills (e.g. effective communication, interpersonal problem solving cooperation)
    • Promote prosocial peer relationships and activities

Essential Components

The essential components of Parenting Through Change (PTC) include:

  • Weekly parent group sessions introduce a set of core parenting practices:
    • Skill encouragement
    • Limit setting
    • Monitoring
    • Problem solving
    • Positive involvement
  • The weekly sessions also introduce supporting practices:
    • Active communication
    • Emotion regulation
    • Academic promotion
  • Group facilitators use active teaching skills (e.g., role play and problem solving) to introduce and practice skills that support prosocial family functioning and generalizable success in community settings.
  • Example videos and parent handouts are provided as part of PTC and are used by practitioners during group sessions.
  • Sessions are video-recorded so that program fidelity can be assessed.

Parent/Caregiver Services

Parenting through Change (PTC) directly provides services to parents/caregivers and addresses the following:

  • Parents of children with disruptive behavior problems, including oppositional and defiant and conduct problems, externalizing and internalizing behavior problems, and delinquency; families and children at risk for developing the above problems; families undergoing significant transitions; homelessness

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Outpatient Clinic
  • School
  • Telehealth delivery

Homework

Parenting through Change (PTC) includes a homework component:

Weekly home practice assignments provide parents with the opportunity to practice procedures followed with troubleshooting issues that may have arisen.

Languages

Parenting through Change (PTC) has materials available in languages other than English:

Danish, Dutch, Icelandic, Norwegian, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Practitioners to co-lead groups, recruitment/intake staff, adequate and private space for parent groups to meet, space for childcare to be provided during groups, if applicable, digital video recording devices (e.g., hand-held cameras, tablets, webcams) with external microphones, computers or tablets connected to the Internet, video conferencing capability.

Minimum Provider Qualifications

Qualifications required for practitioners depend on the agencies that employ them. Practitioners may have Bachelor’s, Master’s, or Doctorate level degrees as entry qualifications. To become a PTC certified practitioner, they must complete an extensive training program. No other specialized training is required. Practitioners serve in a wide variety of delivery systems including child welfare, juvenile justice, and child mental health.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
  • Anna Suski, Administrator Implementation Sciences International, Inc. (ISII)

    phone: (541) 485-2711
Training is obtained:

Onsite, virtually

Number of days/hours:

Varies, depending on the delivery format; a typical training program includes 2-5 workshops for a total of 10-14 workshop days.

Implementation Information

Since Parenting through Change (PTC) is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Parenting through Change (PTC) as listed below:

Implementation Sciences International, Inc. (ISII) is a non-profit affiliate of the Oregon Social Learning Center and oversees the implementation of PTC. Readiness checklists are tailored for various types of implementations. Additionally, there is an FAQ document that assists interested organizations in determining if PTC is a good fit. Prior to the start of training, the ISII team may conduct on-site visits with agency leaders and supervisors to provide a brief overview of PTC, the research basis, and intervention components. The purpose is to advise about requirements and to ensure agency readiness (i.e., candidate recruitment, agency agreement on the components necessary for sustainability).

Formal Support for Implementation

There is formal support available for implementation of Parenting through Change (PTC) as listed below:

Laura Rains, the Director of Implementation and Training at Implementation Sciences International, Inc (ISII), within the Oregon social Learning Center, designs the training programs and infrastructure protocol, as well as provides training, coaching, and coordination for implementation projects. Additionally, she leads a team of trainers and consultants who are available to provide support for all implementation objectives. The ISII website (www.isii.net) provides individual descriptions and roles for staff, mentors, and associates.

Fidelity Measures

There are fidelity measures for Parenting through Change (PTC) as listed below:

Competent adherence to PTC is assessed with the Fidelity of Implementation Rating System (FIMP). FIMP ratings are made by reliable certified PTC specialists and assess the intervention as delivered in parent groups. Ratings are based on direct observation of segments of sessions based on core parenting components and evaluate five theoretically relevant categories (i.e., knowledge, structure, teaching, process skills, and overall development). Procedures, definitions of core parenting practices, and the rating scale are described in a manual. Please contact the program representative for more information.

Implementation Guides or Manuals

There are implementation guides or manuals for Parenting through Change (PTC) as listed below:

Manuals are required for implementation and are provided to those who receive training in PTC (provided at workshops). Additionally, manuals are provided to clinicians who go through training to become PTC Trainers.

Research on How to Implement the Program

Research has not been conducted on how to implement Parenting through Change (PTC).

Relevant Published, Peer-Reviewed Research

This program is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The program must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. The article(s) below that reports outcomes from an RCT showing a sustained effect of at least 1 year 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

Show relevant research...

*Forgatch, M. S., & DeGarmo, D. S. (1999). Parenting through change: An effective parenting training program for single mothers. Journal of Consulting and Clinical Psychology, 67, 711-724.

Type of Study: Randomized controlled trial
Number of Participants: 238

Population:

  • Age — Children: Mean=7.8 years, Parents: Mean=34.8 years
  • Race/Ethnicity — Children: 86% White, 2% Latino, 2% Native American, 1% African American, and 9% Other; Parents: Not specified
  • Gender — Children: 100% Male, Parents:100% Female
  • Status — Participants were single mothers recruited through media advertisements, flyers and court divorce records.

Location/Institution: Pacific Northwest

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study tested the efficacy of the Parenting Through Change (PTC) program on positive parenting practices (discipline, positive involvement, monitoring, problem solving, and skill encouragement). Mothers were randomly assigned to either PTC or no-intervention control condition. Parenting practices were assessed through direct observation of mother-child interactions in the laboratory. Measures utilized include the Teacher Report Form, the Chedoke-McMaster Teacher Questionnaire, the Child Depression Inventory (CDI), and the Child Behavior Checklist. Results indicate that over a 12-month period mothers in the PTC group reduced their use of negative reinforcement and negative reciprocity, whereas mothers in the control group increased theirs. Additionally, whereas mothers in both groups showed a decline in positive involvement with their sons over 12 months, PTC mothers showed significantly less decline than did control-group mothers. Limitations include reliance on self-reported measures, generalizability due to gender of participants, and lack of follow-up.

Length of postintervention follow-up: 6 months.

*Martinez, C. R., Jr., & Forgatch, M. S. (2001). Preventing problems with boys' noncompliance: Effects of a parent training intervention for divorcing mothers. Journal of Consulting and Clinical Psychology, 69, 416-428.

Type of Study: Randomized controlled trial
Number of Participants: 238

Population:

  • Age — Children: Mean=7.8 years, Parents: Mean=34.8 years
  • Race/Ethnicity — Children: 86% White, 2% Latino, 2% Native American, 1% African American, and 9% Other; Parents: Not specified
  • Gender — Children: 100% Male, Parents:100% Female
  • Status — Participants were single mothers recruited through media advertisements, flyers and court divorce records.

Location/Institution: Pacific Northwest

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study utilizes information from Forgatch & DeGarmo (1999). This study tested the efficacy of the Parenting Through Change (PTC) program on coercive discipline, positive parenting practices, and child noncompliance. Mothers were randomly assigned to either PTC or no-intervention control condition. Parenting practices were assessed through direct observation of mother-child interactions in the laboratory. Measures utilized include the Teacher Report Form, the Chedoke-McMaster Teacher Questionnaire, the Child Depression Inventory (CDI), and the Child Behavior Checklist. Results indicate that participants in the PTC group maintained stable outcome trajectories at 12-, 18- and 30-month assessment, whereas those in the control group deteriorated. Limitations include reliance on self-reported measures, generalizability due to gender of participants and lack of follow-up.

Length of postintervention follow-up: None.

*DeGarmo, D. S., Patterson, G. R., & Forgatch, M. S. (2004). How do outcomes in a specified parent training intervention maintain or wane overtime? Prevention Science, 5(2), 73-89.

Type of Study: Randomized controlled trial
Number of Participants: 238

Population:

  • Age — Children: Mean=7.8 years, Parents: Mean=34.8 years
  • Race/Ethnicity — Children: 86% Caucasian, 2% Latino, 2% Native American, 1% African American, and 9% Other; Parents: Not specified
  • Gender — Children: 100% Male, Parents: 100% Female
  • Status — Participants were recently separated mothers with sons recruited through media, community, and divorce court records.

Location/Institution: Eugene, OR

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: The study used the same sample as Forgatch & DeGarmo (1999). The study evaluated the effectiveness of group-based Parent Management Training (PMT) [now called Parenting Through Change (PTC)] in treating disruptive behaviors in a sample of children with newly divorced mothers. Participants were randomly assigned to PMT or a control group. Measures utilized included the CESD Scale, the Child Behavior Checklist (CBCL), the Child Depression Inventory (CDI), and the Loneliness in Children Scale. Findings showed that (a) intervention effects associated with reductions in maternal depression were mediated by changes in boy externalizing, (b) intervention effects on boys externalizing was mediated by changes in boy internalizing, and (c) improved parenting practices predicted both reductions in internalizing and externalizing. The intervention effect on internalizing was only partially mediated by parenting practices. However, as expected, changes in parenting were associated with changes in boys’ externalizing behavior and with equally modest changes in child internalizing. Limitations include generalizability to other populations due to ethnicity and reliance on self-report measures.

Length of postintervention follow-up: 2.5 years.

Patterson, G. R., DeGarmo, D., & Forgatch, M. S. (2004). Systematic changes in families following prevention trials. Journal of Abnormal Child Psychology, 32(6), 621-633.

Type of Study: Randomized controlled trial
Number of Participants: 238

Population:

  • Age — Children: Mean=7.8 years, Parents: Mean=34.8 years
  • Race/Ethnicity — Children: 86% Caucasian, 2% Latino, 2% Native American, 1% African American, and 9% Other; Parents: Not specified
  • Gender — Children: 100% Males, Parents: 100% Female
  • Status — Participants were recently separated mothers with sons recruited through media, community, and divorce court records.

Location/Institution: Eugene, OR

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as Forgatch & DeGarmo (1999). The study evaluated the effectiveness of the group-based Parent Management Training (PMT) [now called Parenting Through Change (PTC)] in treating disruptive behaviors in a sample of children with newly divorced mothers. Participants were randomly assigned to an intervention or control group. Measures utilized include the Teacher Report Form, the Chedoke-McMaster Teacher Questionnaire, the Child Depression Inventory (CDI), and the Child Behavior Checklist. Analyses in the current study looked at the sequence of changes occurring within the family. The authors conclude that PMT was associated with a reduction in externalizing behaviors in boys, which related to improvements in maternal depression. Parent behavior in the treatment group was also shown to have improved internalizing behavior in boys. Limitations include the current sample was recruited by self-selection and may not be representative of the overall population and reliance on self-reported measures.

Length of postintervention follow-up: 2.5 years.

Forgatch, M. S., Patterson, G. R., DeGarmo, D. S., & Beldavs, Z. G. (2009). Testing the Oregon delinquency model with 9-year follow-up of the Oregon Divorce Study. Development and Psychopathology, 21, 637-660.

Type of Study: Randomized controlled trial
Number of Participants: 238

Population:

  • Age — Children: Mean=7.8 years, Parents: Mean=34 years
  • Race/Ethnicity — Children: 86% Caucasian, 2% Latino, 2% Native American,1% African American, and 9% Other; Parents: Not specified
  • Gender — Children: 100% Male, Parents: 100% Female
  • Status — Participants were at-risk single mothers of children with disruptive and delinquent behaviors in classroom settings.

Location/Institution: Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: The study used the same sample as Forgatch & DeGarmo (1999). The study evaluated the effectiveness of the group-based Oregon Model of Parent Management Training (PMTO) [now called Parenting Through Change (PTC)] intervention in a sample of children with delinquent behaviors. Participants were randomly assigned to PMTO or no treatment control group. Multiple-method assessments included delinquency as measured by teacher reports and official arrest records, parenting skills measured by observations of parent-child interactions, and deviant peer association as reported by boys in the intervention group. Analyses of the 9-year follow-up data indicated that PMTO significantly reduced teacher-reported delinquency and delayed police arrests. As hypothesized, the experiments demonstrated that improving parenting practices and reducing contacts with deviant peers served as mediating mechanisms for reducing rates of adolescent delinquency. Limitations include the largely Caucasian and all male sample, as well as the gap in data collection between the two phases of the study.

Length of postintervention follow-up: 9 years.

Patterson, G. R., Forgatch, M. S., & DeGarmo, D. S. (2010). Cascading effects following intervention. Development and Psychopathology, 22, 949-970.

Type of Study: Randomized controlled trial
Number of Participants: 639

Population:

  • Age — Children: Kindergarten-7th grade; Parents: Not specified
  • Race/Ethnicity — Children: Not specified, Parents: Not specified
  • Gender — Children:100% Male, Parents: 100% Female
  • Status — Participants were families with boys at risk for antisocial behavior.

Location/Institution: Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: The study used the same sample as Forgatch & DeGarmo (1999) in addition to data from other sources. Four different sources for cascade effects were examined using 9-year process and outcome data from a randomized controlled trial of a preventive intervention using the group-based Parent Management Training—Oregon Model (PMTOTM) [now called Parenting Through Change (PTC)]. The social interaction learning model of child antisocial behavior serves as one basis for predicting change. A second source addresses the issue of comorbid relationships among clinical diagnoses. The third source, collateral changes, describes events in which changes in one family member correlate with changes in another. The fourth component is based on the long-term effects of reducing coercion and increasing positive interpersonal processes within the family. New findings from the PMTO 9-year follow-up show that mothers experienced benefits as measured by standard of living (e.g., income, occupation, education, and financial stress) and frequency of police arrests. It is assumed that PMTO reduces the level of coercion, which sets the stage for a massive increase in positive social interaction. In effect, PMTO alters the family environment and thereby opens doors to healthy new social environments. Limitations include limited generalizability due to the largely Caucasian and all male sample populations.

Length of postintervention follow-up: 9 years.

*Bjørknes, R., Kjøbli, J., Manger, T., & Jakobsen, R. (2012). Parent training among ethnic minorities: Parenting practices as mediators of change in child conduct problems. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 61, 101-114. doi:10.1111/j.1741-3729.2011.00683.x

Type of Study: Randomized controlled trial
Number of Participants: 96

Population:

  • Age — Children: 3-9 years, Adults: Mean=33.6 years
  • Race/Ethnicity — 59% Pakastani and 41% Somali
  • Gender — Children: Not specified, Adults: 100% Female
  • Status — Participants were youth with conduct problems and their parents.

Location/Institution: Oslo, Norway

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined parenting practices as mediators of change in child conduct problems in ethnic minority families participating in group-based Parent Management Training-Oregon Model (PMTO) [now called Parenting Through Change (PTC)]. Families were randomized into PMTO or a waiting-list control group. Measures utilized include the Eyberg Child Behavior Inventory and the Parent Practices Interview; all measures were translated into Urdu and Somali. Results indicate a reduction in harsh maternal discipline and an increase in positive parenting. Both the reduction in harsh discipline and the increased positive parenting functioned as mediators of the reduction in child conduct problems. Limitations include generalizability to other ethnic populations, reliability on self-reported measures, and lack of follow-up.

Length of postintervention follow-up: None.

Kjøbli, J., Hukkelberg, S., & Ogden, T. (2013). A randomized trial of group parent training: Reducing child conduct problems in real-world settings. Behaviour Research and Therapy, 51, 113-121.

Type of Study: Randomized controlled trial
Number of Participants: 137

Population:

  • Age — Children: 3-12 years; Parents: Not specified
  • Race/Ethnicity — Children: Not specified; Parents: 92% Norwegian and 8% Other
  • Gender — Children: 50 Females; Parents: Not specified
  • Status — Participants were families of children with conduct problems.

Location/Institution: Norway

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article describes the effectiveness of group-based Parent Management Training, the Oregon Model (PMTO) [now called Parenting Through Change (PTC)] on child conduct problems, social competence, and parenting practices. Families were randomly assigned to group based PMTO or regular services (RS). Measures utilized include the Parenting Practices Interview (PPI), the Eyberg Child Behavior Inventory (ECBI), the Home and Community Social Behavior Scales (HCSBS), the Child Behavior Check List (CBCL), the School Social Behavior Scales (SSBS), and the Teacher Report Form (TRF). Results showed that group-based PMTO had a positive impact on parent ratings of child externalizing behavior, social competence, parental mental health and parenting practices both at the termination of treatment and six months later as compared to the comparison group. Limitations include a small sample size which included predominantly middle to upper middle class families and reliance on self-reported measures.

Length of postintervention follow-up: 6 months.

References

Forgatch, M. S., & Domenech Rodriguez, M. M. (2015). Interrupting coercion: The iterative loops among theory, science, and practice. In T. J. Dishion & J. Snyder (Eds.), The Oxford handbook of coercive relationship dynamics. Oxford Handbooks Online. doi:10.1093/oxfordhb/9780199324552.013.17

Forgatch, M. S., & Patterson, G. R. (2010). Parent Management Training -- Oregon Model: An intervention for antisocial behavior in children and adolescents. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (2nd ed., pp. 159-178). New York: Guilford.

Forgatch, M. S., Patterson, G. R., & Gewirtz, A. H. (2013). Looking forward: The promise of widespread implementation of parent training programs. Perspectives on Psychological Science, 8(6), 682-694. doi:10.1177/1745691613503478

Contact Information

Name: Anna Suski, BS
Agency/Affiliation: Implementation Sciences International, Inc.
Website: www.isii.net
Email:
Phone: (541) 485-2711

Date Research Evidence Last Reviewed by CEBC: March 2016

Date Program Content Last Reviewed by Program Staff: February 2016

Date Program Originally Loaded onto CEBC: October 2017