Brief Behavioral Intervention  (BBI)

Children age 15 months-six years old and their caregivers

The Brief Behavioral Intervention (BBI) is a parent management training program for children with disruptive behavior due to issues such as emotional dysregulation, low frustration tolerance, ADHD, difficult temperament, oppositionality, anxiety, and depression. Parents engage in treatment to structure the environment to match their children’s strengths and specific strategies for categories of behavior.  The goal of BBI is for parents to feel competent managing their child’s unique presentation, helping children learn to regulate their emotions, improve compliance, reduce aggression, increase positive behavior, and reduce functional impairments. 

Marni Axelrad

• Agency/Affiliation: Texas Children’s Hospital/Baylor College of Medicine
• Email: meaxelra@texaschildrens.org
• Phone: (832) 822-1688

The goals of the Brief Behavioral Intervention (BBI) are: 

 For Children: 

• Emotional regulation 

• Remain in age-appropriate environments 

• Improve compliance 

• Reduce aggression 

• Increase positive behavior  

• Reduce functional impairment  

• Improve attachment 

For Caregivers: 

• Learn to give children control over their environment when appropriate 

• Improve ability to use warm and effective parenting strategies 

• Increase feelings of parenting competency 

• Reduce functional impairment  

The essential components of Brief Behavioral Intervention (BBI) include:

• Individual family therapy
• Focus on daily routine to be sure it is age appropriate within the context of the family culture and values paying particular attention to:
  • Sleep
  • Eating
  • Toileting
• Define ABC:
  • Antecedent
  • Behavior
  • Consequence
• Child-directed play
• Use of attention to support child behavior and development
• Giving good instructions
• How to manage aggression

Child/Adolescent Services

Brief Behavioral Intervention  (BBI) directly provides services to children and addresses the following:

• Disruptive behaviors, Depression, Sleep problems, Hyperactivity, Toileting, Emotional dysregulation, Frustration tolerance, Attachment

Parent/Caregiver Services

Brief Behavioral Intervention  (BBI) directly provides services to parents/caregivers and addresses the following:

• Child disruptive behaviors (inclusive of above list), Feelings of competence in managing child behaviors, Attachment, Coregulation

Recommended Intensity

Weekly one-hour session

Recommended Duration

4-8 weeks with booster visits as needed 

Delivery Settings

This program is typically conducted in a(n):

• Hospital
• Outpatient Clinic
• Virtual (Online, Smartphone, Zoom, Telephone, Video, etc.)

Homework

This program does include a homework component.

Parent is supposed to practice strategies between sessions.

Languages

Brief Behavioral Intervention  (BBI) has materials available in the following languages other than English:

• Spanish

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

Resources Needed to Run Program

The typical resources for implementing the program are:

A room with toys

Prerequisite/Minimum Provider Qualifications

In graduate training for behavioral health or licensed behavioral health clinician (e.g., Master’s level therapist, psychologist, psychiatrist) 

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Manual details:  

• Axelrad, M. E., & Chapman, S. (2016). The Brief Behavioral Intervention for preschoolers with disruptive behaviors: A clinical program guide for clinicians. MedEdPORTAL, 12, Article 10376. https://doi.org/10.15766/mep_2374-8265.10376. 

Training Information

There is training available for this program.

Training Contact

Training Type/Location:

Flexible, depending on number of people to train. Implementation support and fidelity measures are also available.

Number of days/hours:

2 days (16 hours) for providers, 3 days (24 hours) for supervisors  

“What is included in the Relevant Published, Peer-Reviewed Research section?“ 

• There are currently no published, peer-reviewed research studies on outcomes with the appropriate target population for the topic area(s) in which Brief Behavioral Intervention  has been reviewed.

• Piersiak, H., Molnar, A., Ravi, S., Estes, E., Coiner, M., Politte-Corn, M., Hare, M., Kujawa, A., & Humphreys, K. (2026). A pilot test of Brief Behavioral Intervention for preschool-aged children with prenatal opioid exposure. Child & Family Behavior Therapy<.i>. Advance online publication. https://doi.org/10.1080/07317107.2026.2640382