GenerationPMTO (Individual Delivery Format)

About This Program

Target Population: Parents of children 2-18 years of age with disruptive behaviors such as conduct disorder, oppositional defiant disorder, and anti-social behaviors

For parents/caregivers of children ages: 2 – 18

Program Overview

GenerationPMTO was formerly known as Parent Management Training - the Oregon Model (PMTO®). GenerationPMTO (Individual Delivery Format) is a parent training intervention that can be used in family contexts including two biological parents, single-parent, re-partnered, grandparent-led, reunification, adoptive parents, and other primary caregivers. This behavioral family systems intervention can be used as a preventative program and a treatment program. It can be delivered through individual family treatment in agencies or home-based and via telephone/video conference delivery, books, audiotapes and video recordings. GenerationPMTO interventions have been tailored for specific child/youth clinical problems, such as externalizing and internalizing problems, school problems, antisocial behavior, conduct problems, deviant peer association, theft, delinquency, substance abuse, and child neglect and abuse. For the group version of GenerationPMTO, please see Parenting Through Change (PTC; GenerationPMTO Group).

Program Goals

The goals of GenerationPMTO (Individual Delivery Format) include:

  • Increasing positive parenting practices
  • Reducing coercive family processes
  • Reducing and preventing internalizing and externalizing behaviors in youth
  • Reducing and preventing substance use and abuse in youth
  • Reducing and preventing delinquency and police arrests in youth
  • Reducing and preventing out-of-home placements in youth
  • Reducing and preventing deviant peer association in youth
  • Increasing academic performance in youth
  • Increasing social competency and peer relations in youth
  • Promoting reunification of families with youngsters in care

Essential Components

The essential components of the GenerationPMTO (Individual Delivery Format) include:

  • Parents are the focus of the GenerationPMTO intervention because they are the presumed agents of change; however, parents, focal youth, and the family should all benefit from the intervention and all can participate in the intervention.
  • Core components of GenerationPMTO
    • Skill encouragement, teaching positive behavior
    • Systematic, mild consequences for negative behavior
    • Monitoring and supervision
    • Interpersonal problem solving
    • Positive involvement
  • Supporting components of GenerationPMTO
    • Providing clear directions
    • Observing and recording behavior
    • Identifying and regulating emotions
    • Fostering effective communication
    • Promoting school success
  • Important therapeutic strategies in GenerationPMTO focus on:
    • Identifying and building on strengths
    • Supporting and encouraging effective parenting skills
    • Using sophisticated clinical practices to build therapeutic alliance, provide a supportive environment for change, and engage in treatment completion
    • Preventing and managing resistance
    • Supporting couples, divorced parents, other caregivers to work toward common goals such as a united parenting front for the positive adjustment of their children
    • Active teaching that includes modeling, role play, problem solving, and other experiential exercises that provide opportunity for practice with coaching
    • Promoting positive family system changes
    • Incorporating effective interpersonal problem solving skills
    • Prompting goal behaviors from parents
    • Supporting parents as their children’s most important teachers

Program Delivery

Parent/Caregiver Services

GenerationPMTO (Individual Delivery Format) directly provides services to parents/caregivers and addresses the following:

  • Parents of youngsters with or at risk for internalizing and externalizing behaviors, substance use and abuse, delinquency, police arrests, out-of-home placement, and deviant peer association; parents who may be depressed, highly stressed, living in poverty or high-crime neighborhoods, Spanish-speaking immigrants, families with a military parent returning from war (e.g., Iraq/Afghanistan) who may be experiencing posttraumatic stress disorder (PTSD), families living in shelters or supportive housing because of homelessness or domestic violence, birth parents whose children are in care because of abuse/neglect, and families with transitions such as divorce, single parenting, and step-families,
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: This program involves the family or other support systems in the individual's treatment. Children/adolescents participate in individual family sessions as appropriate or desired. Other family members can be part of the intervention in family sessions.

Recommended Intensity:

60-minute weekly individual/family sessions

Recommended Duration:

10-25 individual/family sessions, depending on severity; 3-6 months or longer, depending on circumstances. For mild problems or prevention, 6-8 sessions.

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Community Agency
  • Community Daily Living Settings
  • Outpatient Clinic
  • Online via Website
  • Via Telephone

Homework

GenerationPMTO (Individual Delivery Format) includes a homework component:

Weekly home practice assignments are tailored for family context; parents practice in session before trying it out at home. Mid-week calls are conducted to troubleshoot and promote success.

Languages

GenerationPMTO (Individual Delivery Format) 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:

All sessions are video recorded and uploaded to HIPAA-compliant website for coaching/supervision, fidelity rating, and certification. Thus, video recording equipment, computer, and high speed internet access are required.

Education and Training

Prerequisite/Minimum Provider Qualifications

Qualifications depend on the agencies that employ them. Practitioners may have Bachelor’s, Master’s, or Doctorate level degrees as entry qualifications. To become certified GenerationPMTO specialists, 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:
Training is obtained:

During the workshop training, active teaching techniques provide abundant opportunity for practice (e.g., modeling, video demonstrations, role play, problem solving, experiential exercises, and video-recording of practice followed up with direct feedback). Throughout the course of training, candidates are required to record their sessions with training families. These video materials are uploaded onto a secure portal so that training mentors and coaches can view their sessions and provide detailed coaching feedback.

GenerationPMTO training is supported with regular coaching. Coaching takes place by phone, through videoconferencing, in written format, in person, individually, and in group. The strengths-based coaching is designed to provide the practitioner with support for effective practice in terms of content and therapeutic process using a suite of active teaching strategies. The group reflective coaching process benefits all in training who view video, identify strengths, and role play new strategies. Candidates receive a minimum of 12 coaching sessions based on direct observation of their therapy sessions with training families. There is also an extensive certification process to ensure fidelity.

Number of days/hours:

A typical training program for GenerationPMTO specialists includes 3 workshops for a total of 10 workshop days plus up to 12 coaching sessions, booster workshops and completing the process of certification. The workshop training program, which is designed to promote competent adherence and sustained model fidelity, is tailored for the implementation site. See the implementation section below for more details.

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for GenerationPMTO (Individual Delivery Format) as listed below:

Readiness checklists are tailored for various types of implementations. Additionally, an FAQ document is available that assists interested organizations in determining if GenerationPMTO (Individual Delivery Format) is a good fit. Contact the ISII Business Manager, Anna Snider, for pre-implementation materials at (541) 485-2711 or annas@generationpmto.org.

Formal Support for Implementation

There is formal support available for implementation of GenerationPMTO (Individual Delivery Format) as listed below:

Prior to the start of implementation, the ISII model developer team may conduct on-site visits with agency leaders and supervisors. These pre-implementation meetings are an opportunity for sites to describe their specific context, for model developers to provide information about GenerationPMTO’s research basis, intervention components, training program, engagement strategies, to advise about requirements, for collaboration about short- and long-term goals, and to ensure readiness. Implementation Sciences International, Inc. (ISII), which is a non-profit affiliate of the Oregon Social Learning Center, oversees the implementation of GenerationPMTO. The Director of Implementation and Training designs the training programs and infrastructure protocol. They also provide training, coaching, and coordination for implementation projects. The director leads a team of trainers and consultants who are available to provide support for all implementation objectives. The ISII website (www.generationpmto.org) provides individual descriptions and roles for staff, mentors, and associates.

Fidelity Measures

There are fidelity measures for GenerationPMTO (Individual Delivery Format) as listed below:

Competent adherence to GenerationPMTO is assessed with the Fidelity of Implementation Rating System (FIMP). The Director of Fidelity, oversees fidelity operations for GenerationPMTO implementation sites. FIMP ratings are made by reliable certified GenerationPMTO specialists who assess the intervention as delivered with individual families in community or home settings. 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 the FIMP manual. Interested parties can contact the ISII Business Manager, Anna Snider, for the fidelity measure. She is available at (541) 485-2711 or annas@generationpmto.org.

Implementation Guides or Manuals

There are implementation guides or manuals for GenerationPMTO (Individual Delivery Format) as listed below:

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

Research on How to Implement the Program

Research has been conducted on how to implement GenerationPMTO (Individual Delivery Format) as listed below:

  • Akin, B. A., Testa, M. F., McDonald, T. P., Melz, H., Blase, K. A., & Barclay, A. (2014). Formative evaluation of an evidence-based intervention to reduce long-term foster care: Assessing readiness for summative evaluation. Journal of Public Child Welfare, 8, 354-374. doi:10.1080/15548732.2014.939250
  • Bryson, S. A., Akin, B. A., Blase, K. A., McDonald, T., & Walker, S. (2014). Selecting an EBP to reduce long-term foster care: Lessons from a university-child welfare agency partnership. Journal of Evidence-Based Social Work, 11, 208-221. doi:10.1080/15433714.2013.850325
  • Forgatch, M. S., & DeGarmo, D. S. (2011). Sustaining fidelity following the nationwide PMTO implementation in Norway. Prevention Science, 12, 235- 246.
  • 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, 682- 694.
  • Hukkelberg, S., & Ogden, T. (2013). Working alliance and treatment fidelity as predictors of externalizing problem behaviors in Parent Management Training. Journal of Consulting and Clinical Psychology, 81, 1010-1020. doi:10.1037/a0033825
  • Ogden, T., Bjornebekk, G., Kjobli, J., Patras, J., Christiansen, T., Taraldsen, K., & Tollefsen, N. (2012). Measurement of implementation components ten years after a nationwide introduction of empirically supported programs-a pilot study. Implementation Science, 7(1), 49.
  • Tømmeraas, T., & Ogden, T. (2015). Is there a scale-up penalty? Testing behavioral change in the scaling up of Parent Management Training in Norway. Administration and Policy in Mental Health and Mental Health Services Research, Online first 29 December, 1-14. doi: 10.1007/s10488-015-0712-3

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

A meta-analysis, see citation following, has been conducted GenerationPMTO (Individual Delivery Format) though this article is not used for rating and therefore is not summarized:

  • Forehand, R., Lafko, N., Parent, J., & Burt, K. B. (2014). Is parenting the mediator of change in behavioral parent training for externalizing problems of youth? Clinical Psychology Review, 34(8), 608-619. doi:10.1016/j.cpr.2014.10.001

Patterson , G. R., Chamberlain, P., & Reid, J. B. (1982). A comparative evaluation of a parent-training program. Behavior Therapy, 13, 638-650. doi:10.1016/S0005-7894(82)80021-X

Type of Study: Randomized controlled trial
Number of Participants: 19 children and 19 parents

Population:

  • Age — Children: 3-12 years, Parents: Not specified
  • Race/Ethnicity — Children: Not specified, Parents: Not specified
  • Gender — Children: 69% Male and 31% Female, Parents: Not specified
  • Status — Participants were families with children and adolescents with highly disruptive, antisocial, and aggressive behaviors who were referred by pediatricians, school or mental health personnel, and by parent self-referral.

Location/Institution: Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] in a sample of children with highly aggressive behavior Participants were randomly assigned to PMTO or to a waiting-list comparison group. Measures used included the Family Interaction Coding System (FICS), Total Aversive Behavior (TAB) score, and the Parent Daily Report (PDR). Results indicated that relative to the changes in the comparison sample, the parent training sample showed a significantly greater reduction in the observed rates of deviant child behavior. Limitations include a small sample size and lack of follow-up.

Length of postintervention follow-up: None.

*Bank, L., Marlowe, J. H., Reid, J. B., Patterson, G. R., & Weinrott, M. R. (1991). A comparative evaluation of parent-training interventions for families of chronic delinquents. Journal of Abnormal Child Psychology, 19(1), 15-33. doi:10.1007/BF00910562

Type of Study: Randomized controlled trial
Number of Participants: 55 children and 55 parents

Population:

  • Age — Children: Mean=14 years, Parents: Not specified
  • Race/Ethnicity — Children: Not specified, Parents: Not specified
  • Gender — Children:100% Male, Parents: Not specified
  • Status — Participants were families of chronically offending youth referred by juvenile court.

Location/Institution: Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] in a sample of chronically offending youth. Participants were randomly assigned to a parent training intervention or a control group receiving services as usual. Measures used included official offense reports and two family measures to record behavior: the Family Interaction Coding System (FICS) and the Parent Daily Report (PDR). Results indicated that participants in the intervention group experienced a reduction in serious crimes during the year of treatment, and both groups demonstrated reduced rates of offending during the follow-up years. Boys in the intervention group also spent significantly less time in institutional settings than did boys in the control group. Parent training had a significant impact, but the reduction in offending was produced at very high emotional cost to staff, as the work with these families was very difficult. Limitations include small sample size and generalizability due to gender of participants.

Length of postintervention follow-up: 3 years.

*Forgatch, M. S., DeGarmo, D. S., & Beldavs, Z. G. (2005). An efficacious theory-based intervention for stepfamilies. Behavior Therapy, 36(4), 357-365

Type of Study: Randomized controlled trial
Number of Participants: 110 families (mother, stepfather, and child[ren])

Population:

  • Age — Children: Mean=7.47 years, Parents: Mothers-Mean=31.3 years and Stepfathers-Mean=32.7 years
  • Race/Ethnicity — Children: Not specified, Parents: Not specified
  • Gender — Children: 70% Male and 30% Female, Parents: 50% Male and 50% Female
  • Status — Participants were families with stepfathers and children with disruptive behaviors who participated in the Marriage and Parenting in Stepfamilies (MAPS) intervention or were randomly assigned to a no-treatment control group; participants were recruited through local advertisements.

Location/Institution: Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Oregon model of Parent Management Training (PMTO) [now called GenerationPMTO (Individual Delivery Format)] intervention in treating disruptive behaviors in children in a sample of families with stepfathers. Families who had participated in the MAPS program were randomly assigned to PMTO or to a no-treatment control group. Family interactions were scored using the Family and Peer Process Code (FPP); parenting practices and child behaviors were scored. Results indicated that participants in the PMTO intervention group displayed a large effect in benefits to effective parenting practices with resultant decreases in child noncompliance and in home and school problem behaviors. Limitations include the small sample size and lack of diversity in the sample, which could limit the potential generalizability of the specific findings of this study.

Length of postintervention follow-up: 2 years.

*DeGarmo, D. S., & Forgatch, M. S. (2007). Efficacy of parent training for stepfathers: From playful spectator and polite stranger to effective stepfathering. Parenting Science and Practice, 7(4), 331-355. doi:10.1080/15295190701665631

Type of Study: Randomized controlled trial
Number of Participants: 110 families (mom, stepfather, and child[ren])

Population:

  • Age — Children: Mean=7.47 years, Parents: Not specified
  • Race/Ethnicity — Not specified
  • Gender — Children: 70% Male and 30% Female, Parents: 50% Male and 50% Female
  • Status — Participants were families with stepfathers and children with disruptive behaviors who were recruited through local advertisements.

Location/Institution: Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: The study used the same sample as Forgatch, DeGarmo, & Beldavs (2005). The study evaluated the effectiveness of the Oregon model of Parent Management Training (PMTO) [now called GenerationPMTO (Individual Delivery Format)] intervention in treating disruptive behaviors in children in a sample of families with stepfathers. Participants were randomly assigned to PMTO or a no-treatment control group. Structured interactions of mothers and stepfathers with children were coded from videotapes using the Family and Peer Process Code. The coding focused on skill encouragement, positive involvement, problem solving, monitoring and supervision, coercive discipline, negative reciprocity, and negative engagement. Children's noncompliance was also coded. In addition, children were administered the Children's Depression Inventory (CDI) and the Loneliness in Children Scale. Results showed that stepfathers in the intervention condition showed improvements at 6 and 12 months, but that these diminished somewhat at 24 months. Limitations include the relatively small sample size and lack of diversity in the sample.

Length of postintervention follow-up: 2 years.

Ogden, T., & Hagen, K. A. (2008). Treatment effectiveness of Parent Management Training in Norway: A randomized controlled trial of children with conduct problems. Journal of Consulting and Clinical Psychology, 76(4), 607-621. doi:10.1037/0022-006X.76.4.607

Type of Study: Randomized controlled trial
Number of Participants: 112 children and 112 parents

Population:

  • Age — Children: 4-12 years, Parents: Not specified
  • Race/Ethnicity — Children: Not specified, Parents: Norwegian and Western European
  • Gender — Children: 80% Male and 20% Female, Parents: Not specified
  • Status — Participants were families with children with disruptive behaviors who were referred from community health centers.

Location/Institution: Norway

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] intervention in a sample of Norwegian families. Participants were randomly assigned to an intervention or to a regular services comparison group. Children and families were assessed using the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), Social Skills Rating System (SSRS), Family Satisfaction Survey, Parent Daily Report (PDR), Fidelity of Implementation System (FIMP), Coder’s Impression (CI), Structural Interaction Tasks (SIT), and the Family and Peer Process Code (FPPC). Results indicated that PMTO was effective in reducing parent-reported child externalizing problems, improving teacher-reported social competence, and enhancing parental discipline. Limitations include the small number of female children subjects and the lack of postintervention follow-up.

Length of postintervention follow-up: None.

*Amlund Hagen, K., Ogden, T., & Bjørnebekk, G. (2011). Treatment outcomes and mediators of parent management training: A one-year follow-up of children with conduct problems. Journal of Clinical Child & Adolescent Psychology, 40(2), 165-178. doi:10.1080/15374416.2011.546050

Type of Study: Randomized controlled trial
Number of Participants: 112 children and 112 parents

Population:

  • Age — Children: 4-12 years; Parents: Not specified
  • Race/Ethnicity — Children: 100% Norwegian, Parents: Not specified
  • Gender — Children: 90 Males and 22 Females, Parents: Not specified
  • Status — Participants were children whose families had contacted the child welfare or child mental health agencies because of child conduct problems.

Location/Institution: Norway

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article describes the effectiveness of Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] on Norwegian children with conduct problems. Families were pairwise randomly assigned to PMTO or regular services (RS). Measures utilized include the Child Behavior Checklist (CBCL), the Teacher Report Form (TRF), the Social Skills Rating System (SSRS), the Parent Daily Report (PDR), the Family Adaptability and Cohesion Evaluation Scale, the Interpersonal Support Evaluation List, and the Working Alliance Inventory 12-item Short Form (WAI-S). Results showed two-parent families in PMTO showed greater reduction in or less observed aversive behavior compared to their RS counterparts at follow-up. Additionally, PMTO children were rated by their teachers to have reduced their problem behaviors and increased their social competence relative to RS children and PMTO parents reported increases in family cohesion compared to RS parents at follow-up. Limitations include small sample size, reliance on self-reported measures and high attrition rate.

Length of postintervention follow-up: 12 months.

Hukkelberg, S., & Ogden, T. (2013). Working alliance and treatment fidelity as predictors of externalizing problem behaviors in Parent Management Training. Journal of Consulting and Clinical Psychology, 81, 1010-1020. doi:10.1037/a0033825

Type of Study: Randomized controlled trial (secondary data analysis)
Number of Participants: 331 children and their parents

Population:

  • Age — Children: 4-12 years, Parents: Not specified
  • Race/Ethnicity — Children: Not specified, Parents: Norwegian and Western European
  • Gender — Children: 80% Male and 20% Female, Parents: Not specified
  • Status — Participants were families with children with disruptive behaviors who were referred from community health centers:

Location/Institution: Norway

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study investigated treatment fidelity and working alliance in the Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] utilizing longitudinal data from the National Institute on Drug Abuse study (see Ogden & Hagen, 2008 above), and investigated how these relate to children’s externalizing problem behaviors, as reported by parents and teachers. Measures utilized include the Child Behavior Checklist (CBCL), Teacher Report Form (TRF), Parent Daily Report (PDR), Working Alliance Inventory short form (WAI-S), and the Fidelity of Implementation Rating Scale (FIMP). Parents rated the client-therapist working alliance at 3 time points (Sessions 3, 12, and 20). Competent adherence to the PMTO treatment protocol was assessed by PMTO specialists from evaluations of videotaped therapy sessions using the Fidelity of Implementation (FIMP) system. Results indicated that parents reported high and stable levels of alliance and and observers reported high levels of fidelity from Time 1 to Time 3, with no correlational or direct relations between the 2 measures.   Treatment fidelity predicted reductions in parent-reported externalizing behavior, whereas working alliance was related to less change in problem behavior. Alliance and fidelity were unrelated to teacher-reported behavior problems. Limitations include attrition, possible rater bias, and lack of follow-up.

Length of postintervention follow-up: None.

Akin, B. A., Testa, M. F., McDonald, T. P., Melz, H., Blase, K. A., & Barclay, A. (2014). Formative evaluation of an evidence-based intervention to reduce long-term foster care: Assessing readiness for summative evaluation. Journal of Public Child Welfare, 8(4), 354-374. doi:10.1080/15548732.2014.939250

Type of Study: Randomized controlled trial
Number of Participants: Children: 59, Parents: 60

Population:

  • Age — Children: 3-16 years; Parents: Not specified
  • Race/Ethnicity — Children: Not specified Parents: Not specified
  • Gender — Children: 52% Female; Parents: Not specified
  • Status — Participants were children involved in the child welfare system with serious emotional disturbance (SED) and their parent(s).

Location/Institution: Not specified

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article describes the Kansas Intensive Permanency Project (KIPP) effort to test the effectiveness of Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] on the well-being and permanency outcomes for families of children with serious emotional disturbance (SED). Children who were identified as having an SED were randomized into PMTO or services as usual. Measures utilized include the Child and Adolescent Functional Assessment Scale (CAFAS), the Preschool and Early Childhood Functional Scale (PECFAS), the Family Interaction Task (FIT), the North Carolina Family Assessment Scale (NCFAS), and the Social Skills Improvement System (SSIS). Results showed that PMTO was associated with higher rates of reunification for treatment families as compared to families receiving services as usual at follow-up. Limitations include small sample size, reliance on self-reported measures and high attrition rate.

Length of postintervention follow-up: 6 months.

Sigmarsdóttir, M., Thorlacius, Ö., Guðmundsdóttir, E. V., & DeGarmo, D. S. (2015). Treatment effectiveness of PMTO for children´s behavior problems in Iceland: Child outcomes in a nationwide randomized controlled trial. Family Process, 54(3), 498–517. doi:10.1111/sjop.12078

Type of Study: Randomized controlled trial
Number of Participants: 102 parent-child pairs

Population:

  • Age — Children: 5-12 years; Parents: Not specified
  • Race/Ethnicity — Children: 100% White Icelandic, Parents: 100% White Icelandic
  • Gender — Children: 73% Boys and 27% Girls, Parents: Not specified
  • Status — Participants were children with behavior problems and their parents. 

Location/Institution: 5 municipalities throughout Iceland

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study reports the efficacy of Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] on children with behavior problems. Families were randomly assigned to either PMTO or services usually offered in the communities (SAU). Measures utilized include the Child Behavior Checklist-Parent Report, the Social Skills Rating System (SSRS), the Children’s Depression Inventory (CDI), the TRF-Teacher Report of the Achenbach scales, and the Parent Daily Report (PDR). Results showed that children whose parents received PMTO treatment showed greater improvement in the child adjustment construct in contrast to the families in the comparison group at follow-up. Results also indicated that at follow-up, PMTO treatment produced benefits to children’s adjustment assessing behavior problems, depressive symptoms and social skills. Limitations include generalizability due to ethnicity and reliance on self-reported measures.

Length of postintervention follow-up: 11 months.

Akin, B. A., & McDonald, T. P. (2018). Parenting intervention effects on reunification: A randomized trial of PMTO in foster care. Child Abuse & Neglect, 83, 94-105. doi:10.1016/j.chiabu.2018.07.011

Type of Study: Two-group, longitudinal postrandomized consent trial
Number of Participants: 918

Population:

  • Age — Children: 3-16 years (M=11.8 years); Parents: Not specified
  • Race/Ethnicity — Children: 709 White and 111 Latino; Parents: Not Specified
  • Gender — Children: 427 Females; Parents: Not specified
  • Status — Participants were children with emotional and behavioral problems in the child welfare system.

Location/Institution: Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The aim of the current study was to examine the effects of Parent Management Training – Oregon Model (PMTO) [now called GenerationPMTO (Individual Delivery Format)] model on reunification. Children in foster care with emotional and behavioral problems were randomized to in-home PMTO (n = 461) or services as usual (SAU) (n = 457). Measures utilized include the Child and Adolescent Functioning Assessment Scale (CAFAS) and the Preschool and Early Childhood Functional Scale (PECFAS). Results indicated that reunification rates were 6.9% higher for the PMTO group (62.7%) than the SAU group (55.8%) with 151 days saved per typical child. Results also indicated that intervention completion strengthened effects as PMTO completers’ reunification rates (69.5%) were 13.7% higher than the SAU group (55.8%), and were 15.3% higher than noncompleters (54.2%). Days saved were also greater for completers as compared to the SAU group (299 days) and noncompleters (358 days). Limitations include the postrandomization consent design may exaggerate attrition and dilute intervention effects by including participants who did not indicate an interest to participate and did not adhere to intervention protocol, neither case managers nor courts were blinded to study condition, and lack of follow-up.

Length of postintervention follow-up: None.

Additional References

Forgatch, M. S., & Domenech Rodríguez, M. M. (2016). Interrupting coercion: The iterative loops among theory, science, and practice. In T. J. Dishion & J. J. Snyder (Eds.), Oxford handbook of coercive relationship dynamics (pp. 194-214). New York: Oxford University Press.

Forgatch, M. S., Patterson, G. R., & Friend, T. (2017). Raising cooperative kids: Proven practices for a connected, happy family. Newburyport, MA: Conari Press.

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

Marion S. Forgatch, PhD
Agency/Affiliation: Implementation Sciences International, Inc. (ISII)
Website: www.generationpmto.org
Email:
Phone: (541) 485-2711

Date Research Evidence Last Reviewed by CEBC: July 2018

Date Program Content Last Reviewed by Program Staff: November 2018

Date Program Originally Loaded onto CEBC: October 2009