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.

Logic Model

The program representative did not provide information about a Logic Model for Hitkashrut.

Manuals and Training

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

Implementation Information

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Hitkashrut.

Relevant Published, Peer-Reviewed Research

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. https://doi.org/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, 8% European, 6% North American, 5% African, and 4% South American
  • Gender — Children: 163 Male and 46 Female; 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 basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effectiveness and mechanisms of the Hitkashrut program for early intervention with preschoolers at risk for conduct problems (CP). Participants were randomly assigned to 14-session Hitkashrut co-parent training groups or minimal intervention control groups with referral to local services as necessary. 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 that at both follow-ups, 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 the control group and reliance on self-reported measures.

Length of controlled 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. https://doi.org/10.1007/s10802-016-0163-7

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, 8% European, 6% North American, 5% African, and 4% South American
  • Gender — Children: 163 Male and 46 Female; 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 basic study design, measures, results, and notable limitations)
The study used the same sample as Somech & Elizur (2012). The purpose of the study was to evaluate the effectiveness and mechanisms of the Hitkashrut program for early intervention with preschoolers at risk for conduct problems. Participants were randomly assigned to 14-session Hitkashrut co-parent training groups, or to minimal intervention control groups with referral to local services as necessary. 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 that the Hitkashrut group showed 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 the control group and reliance on self-reported measures.

Length of controlled 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. https://doi.org/10.1007/s10802-018-0412-z

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, 8% European, 6% North American, 5% African, and 4% South American
  • Gender — Children: 163 Male and 46 Female; 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 basic study design, measures, results, and notable limitations)
The study used the same sample as Somech & Elizur (2012). The purpose of the study was 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 remained significant when tested concurrently with the parenting mediator. Participants were randomly assigned to 14-session Hitkashrut co-parent training groups or minimal intervention control groups with referral to local services as necessary. 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 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 Ineffective Parenting (IP) and CU traits in the CU/IP model, and IP mediation in the EC/IP model. The finding that posttreatment EC and CU traits simultaneously mediated treatment effect on follow-up CP supports the hypothesis that parent Intervention (PI) can inhibit disruptive behaviors by strengthening the two inner control systems that are associated with these mediators. 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 controlled postintervention follow-up: 1 year.

Somech, L. Y. (2021). Effortful control mediates the effect of parenting intervention on preschool callous-unemotional traits. Journal of Child and Family Studies, 30(8), 1920–1932. https://doi.org/10.1007/s10826-021-01988-2

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: 100% Jewish; Parents: Not specified
  • Gender — Children: 163 Male and 46 Female; 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 basic study design, measures, results, and notable limitations)
The study used the same sample as Somech & Elizur (2012). The purpose of the study was to use the Hitkashrut Program’s 2-wave dataset to test a temperamentally-driven mechanism in which Effortful Control (EC) is hypothesized to mediate Parent Intervention (PI’s) effect on Callous-unemotional (CU) traits. Participants were randomly assigned to Hitkashrut intervention or to a control group. Measures utilized include Hebrew translated questionnaires, the Child Behavioral Questionnaire, The Eyeberg Child Behavior Inventory, and Cronbach’s CU Assessment. Results indicate that structural modeling showed that the effect of Hitkashrut PI on children’s CU traits was partially mediated by EC. The partial mediational path suggests that the parenting program has both a direct effect on CU traits and an indirect temperament-based mediated effect. Overall, the results suggest that CU traits among young children with CP are malleable following appropriate treatment and affected by improvement in temperamental self-regulatory capacity as indicated by EC. Limitations include that mediational analysis may suggest a mechanism of change but does not prove causality; all measures were parent reports; the Eyeberg Inventory was not adapted for Israeli norms, therefore no normative mean can be defined; no scales were used to measure fidelity; and finally lack of generalizability due to an all Jewish ethnic group.

Length of controlled postintervention follow-up: None.

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: November 2023

Date Program Content Last Reviewed by Program Staff: March 2020

Date Program Originally Loaded onto CEBC: August 2016