Parenting with Love and Limits (PLL)

About This Program

Target Population: Children and adolescents aged 10-18 who have severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, and attention deficit/hyperactivity disorder) and frequently co-occurring problems such as depression, alcohol or drug use, chronic truancy, destruction of property, domestic violence, or suicidal ideation; program also has been used with teenagers with less extreme behaviors and serves both youth in the community and returning home from an out-of-home placement

For children/adolescents ages: 10 – 18

For parents/caregivers of children ages: 10 – 18

Program Overview

PLL combines group therapy and family therapy to treat children and adolescents aged 10-18 who have severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, attention deficit/hyperactivity disorder) and frequently co-occurring problems such as depression, alcohol or drug use, chronic truancy, destruction of property, domestic violence, or suicidal ideation. The program also has been used with teenagers with less extreme behaviors. PLL is also used to serve as an alternative to a residential placement for youth as well as with youth returning back from residential placement such as commitment programs, halfway houses, group homes, or foster homes. PLL teaches families how to reestablish adult authority through consistent limits while reclaiming a loving relationship.

PLL must consist of both of the following:

  • Six multifamily sessions, conducted by one clinician and one co-facilitator, that employ group discussions, videotapes, age-specific breakout sessions, and role-play.
  • Six to eight individual family intensive 1- to 2-hour therapy sessions in an outpatient or home-based setting to practice the skills learned in the group setting. The number of sessions can be increased up to 20 for youth with more severe problems such as involvement with the juvenile or criminal justice system. PLL's integration of group sessions and family therapy is designed to help families apply skills and concepts to real-life situations and prevent relapse.

Program Goals

The goals of Parenting with Love and Limits (PLL) are:

  • Treat children and adolescents who have severe emotional and behavioral problems
  • Teach families how to reestablish adult authority through consistent limits while reclaiming a loving relationship

Logic Model

The program representative did not provide information about a Logic Model for Parenting with Love and Limits (PLL).

Essential Components

The essential components of Parenting with Love and Limits (PLL) include:

  • Combining both group and family therapy together over a six- to eight-week period
  • Having a recommended 6 to 8 adolescents and their families per group
  • Using the Stages of Readiness Scale as an overlay to break parental resistance
  • Assessing fidelity using the following 4 scales plus a manualized curriculum:
    • Video supervision using Interpersonal Process Recall (IPR)- Expert Rating Scale
    • Group Fidelity Checklist - (Therapist Adherence Measure)
    • Family Therapy Fidelity Checklist - (Therapist Adherence Measure)
    • Monthly PLL Report - (Therapist Adherence Measure)

Program Delivery

Child/Adolescent Services

Parenting with Love and Limits (PLL) directly provides services to children/adolescents and addresses the following:

  • Severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, attention deficit/hyperactivity disorder) and frequently co-occurring problems such as depression, alcohol or drug use, chronic truancy, destruction of property, domestic violence, or suicidal ideation

Parent/Caregiver Services

Parenting with Love and Limits (PLL) directly provides services to parents/caregivers and addresses the following:

  • Has a son or daughter aged 10-18 who has severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, attention deficit/hyperactivity disorder) and frequently co-occurring problems such as depression, alcohol or drug use, chronic truancy, destruction of property, domestic violence, or suicidal ideation

Recommended Intensity:

2-hour weekly group sessions with 1 hour of parents and teens meeting together and 1 hour of the parents and teens meeting separately, and 1-2 hour weekly family sessions, as needed

Recommended Duration:

6 weeks for group sessions, and 4 to 20 sessions for family sessions

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Foster / Kinship Care
  • Outpatient Clinic
  • Community-based Agency / Organization / Provider
  • Group or Residential Care

Homework

Parenting with Love and Limits (PLL) includes a homework component:

Participants are expected to practice the skills they learn in both group and family sessions at home

Languages

Parenting with Love and Limits (PLL) has materials available in languages other than English:

Dutch, 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:

Rooms to provide individual and group therapy in and measures, laptop, LCD projector, speakers, printer, laminator

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Master's level degree in counseling related field for clinician; Bachelors degree for co-facilitator or case manager

Manual Information

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

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:
  • Initial 5-day onsite clinical training
  • Semimonthly quality assurance and clinical adherence telephone consultations (2 hours each supervision session)
  • Motivational Interview Training (PLL Specific)
  • Outcome research and analysis that includes an independently conducted, published program evaluation on recidivism rates and clinical effectiveness, if qualify
  • One annual onsite visit, if needed, to observe delivery of the model for quality assurance purposes
  • Videotape supervision of therapist to facilitate treatment fidelity
  • Monthly 1-hour session for Community Based Action Team (Case Management) supervision (Reentry Teams Only)
  • Ongoing consultations as needed to answer questions outside the weekly telephone consultations
  • More information on training can be found at www.gopll.com
Number of days/hours:

Five days of clinical training, 48 weeks of telephone consultations

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Parenting with Love and Limits (PLL) as listed below:

There is a PLL Implementation Checklist and the 8 Laws of Transportability. They are available from the program contact listed at the end of of the program entry.

Formal Support for Implementation

There is formal support available for implementation of Parenting with Love and Limits (PLL) as listed below:

PLL has specific staff dedicated to program implementation assistance, oversight, and supervision. PLL provides each site with a Clinical Supervisor who is dedicated to that site. Additionally, PLL's Director of Implementation, Director of Data and Support Services, and Vice President of Clinical Services, each provide valuable resources to help each site ensure excellence in program implementation and management. As part of PLL implementation procedures, administrators and clinicians at each site are trained and certified in specific areas of program implementation.

Fidelity Measures

There are fidelity measures for Parenting with Love and Limits (PLL) as listed below:

There are four different fidelity measures:

  • Video Supervision Interpersonal Process Recall (IPR) - (Therapist Adherence Measure): The PLL provider submits videotaped sessions from group and coaching sessions to the PLL Supervisor. The PLL Supervisor then reviews the video and scores the therapist based on PLL's scientifically validated fidelity instrument. Once reviewed, the PLL Supervisor selects segments from the video to review with the clinician during supervision sessions.
  • PLL Fidelity Dashboard - (Therapist Adherence Measure): The PLL Fidelity Dashboard is a software application that tracks "real time" client and clinician results. The dashboard tracks such items as completion and attrition rates; referral engagement rates; the number of clients that started the program, dropped out, or are in process; average length of stay; and standardized assessment results along with other results.
  • Group Protocol Checklist - (Therapist Adherence Measure): The Group Protocol Checklist is used to assess treatment fidelity adherence to the PLL group therapy model. Each of the six classes has a scientifically validated checklist of key concepts specific to that class that were either covered or not covered by the therapist. In addition, therapists use a Likert scale to measure how closely they followed the Group Manual.
  • Family Therapy Protocol Checklist - (Therapist Adherence Measure): The Family Therapy Protocol Checklist is a self-report tool used to assess treatment fidelity adherence to the PLL Family Therapy Model. After each family therapy session, the therapist completes each of the areas that assess competency of the major tenets of the PLL Family Therapy Model.

For more information, contact the program contact listed at the end of the program entry.

Implementation Guides or Manuals

There are no implementation guides or manuals for Parenting with Love and Limits (PLL).

Research on How to Implement the Program

Research has not been conducted on how to implement Parenting with Love and Limits (PLL).

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Child/Family Well-Being

Sells, S. P., Early, K. W., & Smith, T. E. (2011). Reducing adolescent oppositional and conduct disorders: An experimental design using the Parenting with Love and Limits® Model. Professional Issues in Criminal Justice,6(3-4), 9–30. https://www.ojp.gov/library/publications/reducing-adolescent-oppositional-and-conduct-disorders-experimental-design

Type of Study: Randomized controlled trial
Number of Participants: 38

Population:

  • Age — 12–17 years
  • Race/Ethnicity — 82% African American, 12% Caucasian, and 1% Hispanic
  • Gender — 57% Male and 43% Female
  • Status — Participants were adolescents within the juvenile court system with oppositional defiant or conduct disorder diagnoses.

Location/Institution: Georgia

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the extent to which active parent and teen involvement in the six-week Parenting with Love and Limits® (PLL) parent education group reduced adolescents’ conduct disorder behaviors; determine whether reductions in conduct disorders would be sustained over a 12-month follow-up period as measured by recidivism, or re-arrest rates; and evaluate whether PLL lowered parent dropout rates and increased levels of motivation, engagement, and group attendance rates. Participants were randomly assigned to either PLL or usual probation services. Measures utilized include the Child Behavior Checklist (CBCL), Parent and Adolescent Readiness Scale (PRS), Index of Parental Attitudes (IPA), and the Parent Adolescent Communication Scale (PACS). Results indicate that the PLL group demonstrated a significant reduction in aggressive behaviors, depression, attention-deficit disorder problems, and externalizing problems as measured by the CBCL. Dropout rates in the PLL group among parents and teenagers were extremely low, with an 85% attendance rate by the parents and an 80% attendance rate by youths, even though attendance was not court-ordered. Compared with the control group, the PLL group significantly improved parents’ readiness to change and resulted in significantly lower recidivism rates (16% PLL vs. 55% control) over a 12-month follow-up period. Limitations include the small number of participants and that the majority of the PLL group was single-parent mothers.

Length of controlled postintervention follow-up: 12 months.

Winokur-Early, K., Chapman, S., & Hand, G. (2013). Family-focused juvenile reentry services: A quasi-experimental design evaluation of recidivism outcomes. Journal of Juvenile Justice, 2(2), 1–22. https://www.safetylit.org/citations/index.php?fuseaction=citations.viewdetails&citationIds[]=citjournalarticle_499999_38

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 354

Population:

  • Age — 16–18 years
  • Race/Ethnicity — 47% White, 44% African American, 9% Multiracial, 7% Hispanic, and 0.3% Native American
  • Gender — 88% Male and 12% Female
  • Status — Participants were juvenile offenders transitioning from residential commitment back to the community.

Location/Institution: St. Joseph County, Indiana

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare Parenting with Love and Limits™ (PLL) re-entry services with standard aftercare to evaluate recidivism outcomes. Participants were matched to standard re-entry cases using propensity score matching (PSM). Measures utilized include administrative data from official offender case information in the Quest Case Management System. Results indicate that youth released from PLL had lower rates of re-offending than those receiving standard aftercare, with statistically significant differences found for subsequent rates of juvenile re-adjudication. Lengths of service were significantly shorter for the treatment sample than for the matched comparison group by an average of 2 months. Limitations include the non-randomization of participants; a relatively small sample size; and the analysis using data from the court database, which was limited in terms of information related to the details of treatment both for the PLL re-entry and the standard aftercare groups.

Length of controlled postintervention follow-up: 12 months.

Karam, E. A., Sterrett, E. M., & Kiaer, L. (2017). The integration of family and group therapy as an alternative to juvenile incarceration: A quasi‐experimental evaluation using Parenting with Love and Limits. Family Process, 56(2), 331–347. https://doi.org/10.1111/famp.12187

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 310

Population:

  • Age — 14–18 years
  • Race/Ethnicity — 70% African American and 30% Caucasian
  • Gender — 74% Male
  • Status — Participants were offenders in the Champaign County, Illinois, juvenile justice system between April 2009 and December 2011.

Location/Institution: Champaign County, Illinois

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate the effectiveness of Parenting with Love and Limits (PLL) for moderate to high-risk juvenile offenders. Participants were either PLL youth or youth receiving treatment as usual. Measures utilized include Child Behavior Checklist (CBCL) and administrative data on recidivism. Results indicate that youth completing PLL had significantly lower rates of recidivism than the treatment as usual comparison group. Parents also reported statistically significant improvements in youth behavior. Lengths of service were also significantly shorter for the treatment sample than the matched comparison group by an average of 4 months. Limitations include the lack of randomization, an insufficient sample size to examine differences between subgroups, the lack of CBCL data form the comparison group, and the lack of youth self-report measures.

Length of controlled postintervention follow-up: 1 year.

Ryon, S. B., Early, K. W., & Kosloski, A. E. (2017). Community-based and family-focused alternatives to incarceration: A quasi-experimental evaluation of interventions for delinquent youth. Journal of Criminal Justice, 51, 59–66. https://doi.org/10.1016/j.jcrimjus.2017.06.002

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 184

Population:

  • Age — Average=16.5–17.1 years
  • Race/Ethnicity — 66 Black and 46 Hispanic
  • Gender — 120 Male
  • Status — Participants were juveniles involved with the Florida Department of Juvenile Justice.

Location/Institution: Florida

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the implementation of Parenting with Love and Limits (PLL) in a state community mental health system to increase the efficiency of services to youth with co-existing internalizing and externalizing functional impairments. Participants were either PLL youth or youth receiving treatment as usual. Measures utilized include administrative data regarding juvenile demographics, prior history, and subsequent offending which were obtained from the Florida Department of Juvenile Justice Information System (JJIS), and subsequent criminal court offending and sentencing data which were obtained from the Florida Department of Law Enforcement (FDLE) and Florida Department of Corrections. Results indicate that youth completing PLL had, on average, lower rates of recidivism. PLL achieved lower rates of reconviction, felony conviction, and subsequent justice system placement (juvenile and adult) one year following the completion of services. Limitations include the lack of randomization, the overall sample size of youth completing PLL probation services in its first few years of operation in Florida was small, placement was potentially biased by the original use of PLL as a diversion program, and the evaluations reported did not include examination of those youth and families who failed to engage in the PLL program.

Length of controlled postintervention follow-up: 12 months.

Sterrett-Hong, E., Karam, E., & Kiaer, L. (2017). Statewide implementation of Parenting with Love and Limits among youth with co-existing internalizing and externalizing functional impairments reduces return to service rates and treatment costs. Administration and Policy in Mental Health and Mental Health Services Research, 44(5), 792–809. https://doi.org/10.1007/s10488-016-0788-4

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 592

Population:

  • Age — 14–18 years
  • Race/Ethnicity — 81% Caucasian
  • Gender — 54% Male
  • Status — Participants were juveniles in the Idaho community mental health (CMH) system.

Location/Institution: Idaho

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the implementation of Parenting with Love and Limits (PLL) in a state community mental health (CMH) system to increase the efficiency of services to youth with co-existing internalizing and externalizing functional impairments. Participants were either PLL youth or youth receiving treatment as usual. Measures utilized include administrative data provided by the Idaho Division of Behavioral Health, the Child and Adolescent Functional Assessment Scale (CAFAS), and the Child Behavior Checklist (CBCL). Results indicate that youth receiving PLL experienced shorter treatment durations and returned to CMH services at significantly lower rates than youth receiving treatment as usual. PLL youth also demonstrated significant decreases in internalizing and externalizing symptoms over time. Limitations include the lack of randomization, a lack of information on youth symptomatology, and the lack of youth self-report of functioning.

Length of controlled postintervention follow-up: 1 year.

Additional References

Sells, S. P. (2001). Parenting your out-of-control teenager. New York: St. Martin's Press.

Sells, S. P., Smith, T. E., & Rodman, J. (2006). Reducing substance abuse through Parenting with Love and Limits. Journal of Child and Adolescent Substance Abuse, 15, 105-115.

Sells, S., Sullivan, I., & DeVore, D. (2012). Stopping the madness: A new reentry system for juvenile corrections. Corrections Today, April/May, 40-45.

Contact Information

Alison Blodgett
Agency/Affiliation: Parenting With Love and Limits, Inc.
Website: www.gopll.com
Email:
Phone: (800) 735-9525

Date Research Evidence Last Reviewed by CEBC: November 2023

Date Program Content Last Reviewed by Program Staff: November 2023

Date Program Originally Loaded onto CEBC: December 2009