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Mindful parenting as a transdiagnostic family process in the development and maintenance of youth psychopathology

Chapter 7
Mindful Parenting
in the Development and Maintenance
of Youth Psychopathology
Justin D. Smith and Thomas J. Dishion
Transdiagnostic models of family process focus on the shared dynamics,
functions, and structure of interaction patterns related to various forms
of youth psychopathology. The promise of a transdiagnostic approach
lies in the development of prevention and intervention strategies that
address multiple adjustment difficulties in children and adolescents (Chu,
2012; Dishion & Stormshak, 2007). In this chapter we propose mindful
parenting as a superordinate construct that describes parents’ efforts to
self- regulate their own emotions, needs, and automatic reaction patterns
in the interest of promoting the short- and long-term well-being of their
children. While developing interventions for families, our research team
at the Child and Family Center has organized family management into
three broad domains: positive behavior support, healthy limit setting and
parental monitoring, and family relationship building (Dishion, Storm-
shak, & Kavanagh, 2012). In this chapter we have organized our discus-
sion of mindful parenting into a brief review of these domains as they
apply to the concept of mindful parenting in transdiagnostic models of
youth psychopathology. The chapter culminates with a critical analysis of
the current state of research in this area and with proposed future direc-
tions for empirical inquiry.
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Mindful Parenting 139
The Concept of Mindful Parenting
Mindful parenting extends the concept of mindfulness (Kabat-Zinn, 2003)
to describe a parent’s ability to be aware, to self- regulate, and to navi-
gate the interpersonal issues (self and other) in parenting (Kabat-Zinn &
Kabat-Zinn, 1997; Steinberg, 2004). Being proactive and monitoring chil-
dren and adolescents is certainly a core aspect of mindful parenting, as is
being aware of and compassionate about the short- and long-term needs
of youth. It is likely that over time all cultures derived unique strategies
for effective parenting, and therefore the instantiation of mindful parent-
ing is likely to vary depending on socioeconomic and cultural context.
The model of mindful parenting put forth by Duncan, Coatsworth,
and Greenberg (2009) posits that “parents who can remain aware and
accepting of their child’s needs through the use of mindfulness practices
can create a family context that allows for more enduring satisfaction and
enjoyment in the parent– child relationship” (p. 256). Mindful parenting,
therefore, fosters higher quality relationships within families. Dishion
and colleagues (2012) present a model of mindful parenting that further
differentiates the parenting skills and intrafamilial processes involved,
the elements of which are discussed in the remainder of this chapter and
depicted in Figure 7.1. We believe positive behavior support, parents’
healthy limit setting, and family relationship building comprise a testable
latent construct of mindful parenting.
The core skills and processes involved in mindful parenting are a
transdiagnostic mechanism, the lack of which contributes to the devel-
opment, amplification, and maintenance of youth psychopathology.
FIGURE 7.1. The elements of mindful parenting and the relationship to psycho-
pathology and family functioning.
Parents’ Healthy
Limit Setting
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Conversely, Dumas (2005) proposed that fostering everyday mindful par-
enting practices can improve the effectiveness of interventions targeting
parenting practices, suggesting that they are likely to be a mechanism of
change for various disorder classes. To date, mindfulness- based parent-
ing interventions have been shown to be effective for improving family
functioning, parenting, parenting satisfaction, and mindful parenting
skills (see Coatsworth, Duncan, Greenberg, & Nix, 2010).
Parental Reactivity and Youth Psychopathology
It is assumed that all forms of youth psychopathology are multideter-
mined and have significant genetic and environmental roots (e.g., Rutter,
2006). A multilevel analysis of psychopathology suggests that gene, brain,
and environment work together to shape underlying mechanisms that in
turn form typical and atypical development (Cicchetti, 1993, 2008). Of
interest, however, is the ubiquity of parenting processes that can amplify
genetic vulnerabilities. From a relationship perspective of developmental
psychopathology, evidence is clear that a key dimension of the environ-
ment is reactive and conflictual close relationships (Beach et al., 2006).
Parent reactivity is intrinsic to parent– child conflict but can also be an
essential aspect of neglect. Parents who are consumed by the concerns
of their personal life can neglect or ignore the needs of their children.
Often, neglect and conflict go hand in hand: cycles of neglect can lead
to severe conflict once a conduct problem is fully developed (Dishion &
Patterson, 2006).
Parent reactivity is implicated in the development and amplifica-
tion of all forms of youth psychopathology, including disruptive behavior
disorders (e.g., Frick & Loney, 2002; Johnston & Mash, 2001; Patterson,
1982; Smith & Farrington, 2004), unipolar and bipolar depression (e.g.,
Alloy, Abramson, Smith, Gibb, & Neeren, 2006; Goodman & Gotlib,
1999; Radke- Yarrow, Ricters, & Wilson, 1988; for a review, see Restifo
& Bogels, 2009; Sheeber & Sorenson, 1998), substance abuse disorders
(e.g., Dishion, Capaldi, & Yoerger, 1999; Liddle & Dakof, 1995), attention-
deficit/hyperactivity disorder (ADHD; e.g., Lindahl, 1998), borderline
personality disorder (Crowell, Beauchaine, & Lenzenweger, 2008), and
schizophrenia (Asarnow & Kernan, 2008; Doane, Goldstein, Miklowitz,
& Falloon, 1986; Falloon et al., 1985). Addressing fractured, conflictual
familial relationships is central to attachment (Bowlby, 1980) and to social
learning theories (Patterson, 1982; Patterson, Reid, & Dishion, 1992) with
regard to development of psychopathology in children and adolescents.
The literature about parenting is vast, and a thorough discussion of
the conceptual and measurement issues underlying a science of parenting
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Mindful Parenting 141
is beyond the scope of this chapter. It is likely that much of the debate
about which parenting constructs are the most important to children’s
development may actually be related to problems of measurement (Dish-
ion, Burraston, & Li, 2003). The literature regarding parenting practices
is challenging to integrate, given inconsistent measurement practices and
construct definitions, which we discuss in greater detail later in this chap-
ter, but there is ample evidence to support the assertion that family pro-
cesses are basic mechanisms involved in the etiology of common youth
mental health disorders and can therefore be the targets of family- based
transdiagnostic interventions.
We discuss the concept of mindful parenting as it applies to fam-
ily management practices, a term originally introduced by Patterson and
colleagues (1992). The key features of family management are parents’
efforts to monitor and attend to children’s behavior and whereabouts,
to consider what is being learned (or conditioned) in a situation, and to
respond patiently and with a vision for the future that integrates com-
passion for the child with beneficence for the child and family. Such an
approach to parenting requires motivated awareness, self- regulation, and
vigilance about the present, similar to the concept of mindfulness often
used in psychology and associated with a state of mind cultivated in medi-
tation. The key that links the concept of individual mindfulness with fam-
ily management is attention to the present detail and responding out of
awareness rather than from emotional reactivity. It is not surprising that
parenting, a process that accounts for successful education of youth and
maintenance of peaceful community, would require a set of skills also
found useful for establishing and maintaining psychological well-being.
To activate mindful parenting, focus is shifted to the interpersonal inter-
action dynamics of one’s family, including those among adult partners
and especially those that involve parents and children.
Our model of mindful parenting incorporates three key parenting
processes that have been empirically demonstrated to be tied to the devel-
opment and maintenance of youth psychopathology: (1) positive behavior
support, which involves paying attention to children’s positive behavior,
proactively setting up situations for children’s success and enjoyment, and
being responsively contingent when noticing positive behavior; (2) healthy
limit setting, which includes parents’ efforts to proactively structure chil-
dren’s lives to ensure that they are supervised by adults and to safeguard
them from potential risks and dangers; and (3) family relationship build-
ing, which consists of daily efforts to communicate with family members
in such a way as to increase mutual understanding and compassion and
to solve problems peacefully, considering each family member’s point of
view. Unlike with individual mindfulness, mindful parenting involves
focusing attention on parent– child transactions rather than on the self.
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Positive Behavior Support
Positive behavior support is a prevalent and effective behavior manage-
ment principle that emphasizes the use of nonaversive, reinforcing adult–
child interactions (e.g., Horner & Carr, 1997; Sugai, Horner, & Sprague,
1999). A core aspect of parenting is to be attentive to children’s efforts, to
be aware of their “zones of proximal development,” and to acknowledge,
reinforce, and support their prosocial efforts. Positive behavior support
includes parenting behaviors such as warmth, praise, positive reinforce-
ment, and monitoring. Integral to positive behavior support and to all
parenting practices is to proactively offer children opportunities to be
successful and to provide learning opportunities and situations that are
rewarding and that minimize conflict and negative interactions (Gard-
ner, 1987). At the foundation of positive behavior support is parents’
willingness to make effective requests of their children or adolescents
and to reinforce positive child behaviors consistent with those requests.
The literature describing the relationship between positive behavior sup-
port and related parenting constructs and later development of problem
behaviors during childhood and adolescence is quite robust. Although an
exhaustive review of this topic is well beyond the scope of this chapter,
following are mentions of notable studies and conceptual models of posi-
tive behavior support that have emanated from research conducted at the
Child and Family Center and its affiliates. Shaw and Gross (2008) found
that negative and neglectful parenting practices of children at 2 years
old are prognostic of later problem behaviors (e.g., interpersonal aggres-
sion, violent crime). Lack of warmth and positive involvement during
early childhood is associated with later problem behaviors (e.g., Gardner,
Sonuga-Barke, & Sayal, 1999; Gardner, Ward, Burton, & Wilson, 2003;
Kashdan et al., 2004; Stormshak, Bierman, McMahon, & Lengua, 2000).
Similarly, lack of parental involvement and inconsistent discipline prac-
tices have been implicated in the etiology of disruptive behavior disorders
in youth (Connor, 2002).
The literature also provides empirical findings regarding the relation-
ship between positive behavior support and unipolar and bipolar depres-
sion. Given its close link to the immediate family context, depression in
youth ought to be associated with family functioning (Stark, Swearer,
Kurowski, Sommer, & Bowen, 1996). Cicchetti and Toth (1998) proposed
that the quality of caregiving an infant receives contributes to variations
in neurobiological growth and development of the infant’s brain, which
results in greater risk for developing depressive symptoms later in life.
Parenting practices are associated with the later development of depres-
sive disorders (e.g., Garber, Robinson, & Valentiner, 1997; Kim & Ge,
2000) and with the co- occurrence of depression and conduct problems
(Ge, Best, Conger, & Simons, 1996). Connell and Dishion (2008) found
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Mindful Parenting 143
that levels of adolescent depression were significantly diminished as a
result of an intervention aimed at increasing positive behavior support
to reduce externalizing behavior problems. The reduction in depression
that has been found to occur with these interventions seems to be a collat-
eral benefit of having improved positive behavior support within the fam-
ily. Another example of this phenomenon comes from a study by Shaw,
Connell, Dishion, Wilson, and Gardner (2009), who found that improve-
ments in positive parenting were associated with reductions in the care-
giver’s depressive symptoms. Other collateral benefits of increasing posi-
tive behavior support can also be found in the intervention literature. For
example, Lunkenheimer and colleagues (2008) found an indirect effect
between improved positive behavior support and child language develop-
ment and inhibitory control. A growing body of evidence supports the
assertion that positive behavior support is a transdiagnostic mechanism
associated with a host of important child and adolescent mental health
indicators and multiple disorder classes, including anxiety, externalizing
behaviors, and depression (e.g., Wood, McLeod, Sigman, Hwang, & Chu,
Mindful parenting is fundamental to positive behavior support strat-
egies. Mindful parents demonstrate compassion for their child by being
aware of the positive impact of reinforcing desired behaviors regardless of
the child’s competing emotions or demands for attention at the time. In
many cases, this approach requires that parents actively inhibit more auto-
matic responses when they feel the child is not listening or is purposely
defying family rules and expectations. Becoming more aware of one’s
emotional reactions to the child and how this awareness can subsequently
lead to specific, improved responses is a defining behavior of the mindful
parent and a core skill promoted in traditional mindfulness practices.
Parental Healthy Limit Setting
The core component of healthy limit setting is monitoring children’s
behavior and whereabouts and safeguarding one’s children. Parental mon-
itoring is a term coined by Gerald Patterson in the 1980s (Patterson, 1982;
Patterson & Stouthamer- Loeber, 1984) to denote parents’ overall involve-
ment with their children and their direct and indirect knowledge of their
children’s safety, behavior, feelings, experiences, and whereabouts (for
a review, see Dishion & McMahon, 1998). Lack of parental monitoring
of adolescents has been shown to be highly predictive of externalizing
behavior problems in boys and in girls (Fosco, Stormshak, Dishion, &
Winter, 2012; Kerr & Stattin, 2000) and is a known correlate of aggres-
sion and antisocial behaviors in children (Connor, 2002). Internalizing
problems are also associated with the absence of monitoring: Kim and
Ge (2000) found that increased use of parental monitoring and inductive
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reasoning practices reduced the risk of youth depression. DiClemente
and colleagues (2001) found that adolescents who perceived less parental
monitoring were more likely to endorse engaging in risky sexual behav-
iors and to test positive for a sexually transmitted disease. They also found
that less monitoring was associated with greater rates of substance use,
which is consistent with the findings of other researchers (e.g., Chilcoat
& Anthony, 1996; Kiesner, Poulin, & Dishion, 2010; Lac & Crano, 2009;
Tobler & Komro, 2010). In a similar vein, Caruthers, Van Ryzin, and Dish-
ion (in press) found that improving parental monitoring by implement-
ing a brief intervention during early adolescence resulted in less high-risk
sexual behaviors reported during early adulthood. Brody (2003) found
that changes in monitoring were related to changes in child externalizing
behaviors over time. He also found that children with difficult tempera-
ments (e.g., low levels of self- regulation) benefited most from parental
monitoring. That is, the relationship between difficult temperament and
externalizing behavior was weaker in well- monitored homes.
Contemporary parent and family intervention models that target
parental monitoring also help parents take constructive action in the
form of setting healthy limits. Externalizing and internalizing problems
occur at a much higher rate when youth experience inconsistent and
harsh parental discipline practices (Connor, 2002; Garber et al., 1997)
and negative, physically aggressive punishment strategies (Kashdan et al.,
2004; Stormshak et al., 2000). Monitoring might have particularly impor-
tant implications for high-risk youth. Increasing parental monitoring has
been found to prevent early-onset substance abuse by high-risk adoles-
cents (Dishion, Nelson, & Kavanagh, 2003). In a longitudinal study, Laird,
Criss, Pettit, Dodge, and Bates (2008) found that better parental mon-
itoring attenuated the relationship between the influence of a deviant
peer group and adolescent delinquent behaviors. The collective empirical
knowledge regarding the relationship between parental monitoring and
various youth mental health and behavioral problems indicates that moni-
toring plays a prominent role in the development of these problems and
could prove to be a robust mechanism of change in parenting and family-
based interventions. To a large extent, mindful parenting contributes to
parental monitoring practices. Parents who are more mindful are likely to
appreciate the positive, long-term outcomes of monitoring their children
and setting healthy limits, even though these practices can be a source of
parent– child disagreement at a time when a less mindful parent might
feel compelled to retract a limit he or she had set.
Family Relationship Building
The literature is quite clear that poor family relationships lead to
increased incidence rates of youth psychopathology. Conflict is inevitable
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Mindful Parenting 145
in close relationships, and the way in which it is resolved determines the
course of a relationship. A parent’s emotional reactivity is one of the best
predictors of poor resolution of conflict (Forgatch, 1989). The coercion
model is one way to understand problematic family relationship dynam-
ics (Patterson et al., 1992). Coercive parenting practices have been linked
to the development and maintenance of nearly all common disorders of
youth (Cummings, Davies, & Campbell, 2000). The coercive- parenting
model continues to guide several parenting interventions for a variety of
youth disorders and is supported by several cross- sectional and longitudi-
nal studies (see Campbell & Patterson, 1995, for a review). The first step
a parent takes in the coercion cycle is to react emotionally to the behavior
of the child. When a behavior upsets parents, they may react in a variety
of ways: they may completely avoid discussing the situation and be angry,
do something to hurt the youth (e.g., yelling, hitting, name calling), or
make requests or demands that are unclear, blaming, or unrealistic and
that lead to more conflict. In turn, the child’s behavior continues or even
escalates, depending on parents’ reactions. When parents take a mindful
approach, they may be able to disrupt the destructive cycle of negativity
and disengagement that at times becomes automatic for some parent–
child dyads (Dishion, Burraston, & Li, 2003). Ongoing involvement in
coercive interactions segues to poorer quality parent– child relationships,
and the youth can develop clinical- level problem behaviors or maintain
those behaviors that are already reinforcing the cycle of coercion in the
family (Patterson et al., 1992).
Conflict can be inherent in the coercion cycle. Familial conflict has
been implicated in the development of unipolar and bipolar depression
(e.g., Du Rocher Schudlich, Youngstrom, Calabrese, & Findling, 2008;
Geller et al., 2002; Sheeber, Hops, Alpert, Davis, & Andrews, 1997; Sheeber
& Sorenson, 1998), substance use (e.g., Repetti, Taylor, & Seeman, 2002),
schizophrenia (Asarnow & Kernan, 2008), borderline personality disorder
(e.g., Weaver & Clum, 1993), and conduct problems (e.g., Bank, Burraston,
& Snyder, 2004; Garcia, Shaw, Winslow, & Yaggi, 2000; Rubin, Burgess,
Dwyer, & Hastings, 2003). Conflict reciprocally influences the other ele-
ments of mindful parenting; for example, parents in conf lict- filled rela-
tionships with their youth may be more likely to disengage, which can
contribute to less parental monitoring and greater risk for youth conduct
or substance use problems (Dishion, Nelson, & Bullock, 2004). Similarly,
conflict contributes to poorer relationships between youth and caregivers,
which inhibits caregivers’ ability to effectively set healthy limits. Barnes,
Brown, Krusemark, Campbell, and Rogge (2007) found that more mind-
ful individuals were more likely to respond constructively to stress in inter-
personal relationships. Increased use of problem- solving skills in the pres-
ence of stress and conf lict can disrupt the coercion cycle and result in
better outcomes for the child and the family. These findings suggest that
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increasing parents’ capacity for mindful parenting is likely to be a key in
the treatment of youth psychopathology when conflict, poor relationships,
and a lack of positive behavior support pervade the family system.
Mindful Parenting as a Mechanism of Change
in Family-Based Intervention
The significance of improved family functioning as a mechanism of
change with respect to youth problems is a long-held, core assumption
among family systems theorists (e.g., Henggeler & Borduin, 1990; Mann,
Borduin, Henggeler, & Blaske, 1990; Sholevar, 2003), yet the literature
provides relatively few empirical findings to support this assumption
(e.g., Kazdin, 2005; Kazdin & Nock, 2003; Shirk & Russell, 1996; Weisz,
Huey, & Weersing, 1998). Identifying common mechanisms of change
is perhaps the key to developing effective transdiagnostic treatment
approaches for youth psychopathology. Yet to date, the evidence from
disorder- specific treatment models that target family processes is some-
what mixed, even though clinicians and researchers generally believe in
the importance of including caregivers and families in the treatment of
youth psychiatric disorders. Despite this belief, the paucity of studies that
include parents in treatment, let alone include them as agents of change,
has been noted in recent reviews (Diamond & Josephson, 2005; Restifo
& Bogels, 2009; Sander & McCarty, 2005). For example, the family is
involved in any capacity in less than one-third (32%) of treatments for
youth depression (Sander & McCarty, 2005). Likewise, only 11% of stud-
ies reviewed by Weisz, McCarty, and Valeri (2006) included the family in
treatment as agents of change.
Literature that identifies family processes as mechanisms of change
in the treatment of youth psychopathology is limited, yet encouraging.
Family processes have been shown empirically to mediate the relation-
ship between treatment and outcome in family- based interventions for
conduct problems in youth (e.g., Barlow & Stewart- Brown, 2000; Dishion
et al., 2008; Woolfenden, Williams, & Peat, 2009), substance abuse disor-
ders (e.g., Liddle, 2004; Liddle & Dakof, 1994), attention- deficit/ hyper-
activity disorder (e.g., Pelham, Wheeler, & Chronis, 1998), schizophrenia
(e.g., McFarlane, Dixon, Lukens, & Lucksted, 2002; Pharoah, Mari, Rath-
bone, & Wong, 2010), and anxiety disorders (e.g., Ginsburg & Schloss-
berg, 2002). The literature about disruptive behavior disorders is the
most robust in this regard. Many empirically supported treatments for
disruptive behavior in youth target multiple levels, most commonly the
child and parent but at times the family as a whole (e.g., Compton et al.,
2004; Loeber, Burke, & Pardini, 2009; Pardini, 2008). The most successful
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Mindful Parenting 147
treatment models typically include intervention components for both the
child and the parents (see Pardini, 2008, for a review), and interventions
focused exclusively on the child are not promising (Burke, Loeber, & Bir-
maher, 2002). Parenting practices, specifically those elements that make
up our mindful parenting construct, have been implicated as mechanisms
of change in family interventions for disruptive behavior disorders (e.g.,
Dishion, Nelson, & Kavanagh, 2003; Dishion, Patterson, & Kavanaugh,
1992; Dishion et al., 2008; Gardner, Burton, & Klimes, 2006; Gardner,
Shaw, Dishion, Burton, & Supplee, 2007; Huey, Henggeler, Brondino, &
Pickrel, 2000; Mann et al., 1990; Smith, Dishion, Moore, Shaw, & Wil-
son, 2013; Smith, Dishion, Shaw, & Wilson, in press; Stoolmiller, Duncan,
Bank, & Patterson, 1993). However, treatments for other common youth
disorders often disregard the family and seldom target family processes
as mechanisms of change.
A relatively strong relationship exists between mindfulness, its
related processes, and psychopathology (see Aldao, Nolen- Hoeksema, &
Schweizer, 2010, for a review). This connection has generated a number of
interventions that target parent and youth mindfulness as a mechanism
of change. Mindfulness- based interventions for children and adolescents
have an inherently intrapsychic focus as opposed to the interpersonal
focus of mindfulness- based interventions for parents, which emphasize
mindfulness in the context of interactions and relationships within the
family. Empirical evidence suggests that mindfulness- based interventions
are effective for reducing individual psychopathology and improving fam-
ily functioning in youth (e.g., Burke, 2010; Lee, Semple, Rosa, & Miller,
2008; Singh, Singh, et al., 2010) and in parents (Cohen & Semple, 2010;
Dumas, 2005; Singh, Lancioni, et al., 2010). The preliminary success of
these mindfulness- based family interventions suggests that mindful par-
enting is likely to be an important mechanism of change in family- based
intervention approaches for various disorder classes and problematic
family relationships.
Future Research on Family Processes as Transdiagnostic Mechanisms
of Change
As transdiagnostic interventions become more prevalent in the child and
adolescent behavioral arena, the need to better understand common fam-
ily processes that contribute to youth problems will increase. To meet this
need, these processes must be more effectively targeted by intervention
and prevention efforts. Intervention scientists would do well to draw on
the developmental and family process literature as they design and test
treatment protocols for youth disorders. This approach is particularly
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apt for transdiagnostic treatments, which target common processes in an
effort to address complex symptom presentations. If intervention scien-
tists are to benefit from this research, epidemiologists and developmental
scientists must broaden the scope of their work beyond single disorders
and disorder classes to include developmental models of comorbid disor-
ders and common symptom profiles.
Construct and measurement issues are one of the challenges inher-
ent in establishing a research agenda for family processes and youth psy-
chopathology. As an example, measures of mindful parenting are needed
that are not culturally narrow. A mixed- method approach grounded in
observation is well suited to the problem of conceptualizing and measur-
ing mindful parenting (Dishion & Patterson, 1999). The first step is to
conduct cross- cultural studies that document the instantiation of mindful
parenting in a variety of cultural and socioeconomic settings. Classic work
by Whiting is an example of this approach (Whiting & Edwards, 1988),
as is the early work of Ainsworth (1989). The second step is to develop
measures that would capture the core dimension of mindful parenting
by using both observational measurement and self- report methods (inter-
view, questionnaire, etc.). This step involves measuring other domains
of parenting, such as positive behavior support, healthy limit setting and
monitoring, and relationship building. With respect to validity, one must
determine whether the mindful parenting measure can be differentiated
from other core dimensions of parenting and whether a superordinate
factor model fits the data. The third and final step would be to design sys-
tematic intervention studies that attempt to increase mindful parenting
to determine whether it can be addressed in prevention and intervention
studies and to identify the extent to which youth benefit from parents’
increased mindfulness. It is possible that for some families, increasing
awareness and consciousness under some circumstances could increase
irritability and negativity, and therefore conflict. Additional research is
needed to better understand these relationships.
Currently, the literature contains a number of self- report measures
of constructs that are likely related to mindful parenting practices, such
as the parent’s general mindfulness (e.g., Brown & Ryan, 2003) and expe-
riential avoidance and acceptance of emotions (Cheron, Ehrenreich, &
Pincus, 2009). Self- report measures probably tap a parent’s capacity for
mindful parenting, but not necessarily mindful parenting behaviors. Our
mindful parenting construct is measured solely by observable parenting
practices and family interactions that demonstrate the act of mindful
parenting. Examining the convergent validity between our construct and
other measures and measurement methods (i.e., self- report) is a necessary
step in understanding the link between a parent’s capacity for mindful-
ness and the ability to put this aptitude into practice in the context of his
or her family.
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Mindful Parenting 149
One exciting potential direction is to develop a program of research
on the neuroscience of parenting. Not directly observable in most mea-
surement paradigms is the degree of intersubjectivity between a parent
and child (Vygotsky, 1986). Intersubjectivity is the shared understanding
between the parent and child about the interpersonal underpinnings
of the relationship, mutual attachment and compassion, and values and
norms. Much of self- regulation is enacted or entrained in the daily inter-
actions of close family members and is only barely available to conscious
recall (Bargh & Williams, 2006). At times, self- regulation in families
becomes conscious and effortful (e.g., Posner & Rothbart, 2000); how-
ever, these occurrences are likely to be only a fraction of the interpersonal
dynamics that form the substrate of regulation in a close relationship.
Given that much of self- regulation involves analysis of neurocognitive
processing over very short periods of time, there is a sense that affective
neuroscience provides the scientific tools for understanding individual
differences in parents’ ability to regulate emotion in the service of inter-
acting positively with their children (Amodio, 2011). Moreover, much of
the action– reaction dynamic in parent– child interaction goes unseen in
that parents and youth mutually self- regulate, for example when they
work toward cooperation and comfort during times of stress. Although
the concept of “internalization” has been key to socialization theories
(Grusec & Goodnow, 1994; Hoffman, 1991; Kochanska, 2002), it has
never been measured as a process. Paradoxically, mindful parenting may
be best understood as an intricately developed unconscious process by
which conscious self- regulation is required only to make minor changes
in the course of the relationship interaction.
Understanding the measurement strategies and interpersonal dynam-
ics of mindful parenting will lead the way to understanding the ways in
which these parenting behaviors lead to change. In the family intervention
literature, greater attention must be given to family- based mechanisms of
change. More exploration of the proposed mechanisms of change in fam-
ily treatment would provide a stronger empirical understanding of which
treatment processes are actually contributing to observed improvements
(Pinsof & Wynne, 2000). As we put forth in this chapter, there is evidence
that the elements of mindful parenting are potentially key elements of
family change processes. Innovative research designs capable of provid-
ing the necessary support for these parenting elements as mechanisms
of change are needed. Developing transdiagnostic treatment models for
youth psychopathology before strong evidence of common change mecha-
nisms is gathered may be somewhat hasty. However, in the current health
care and economic climates the need is greater than ever to develop cost-
effective, evidence- supported treatment approaches for children and ado-
lescents. Transdiagnostic intervention approaches certainly have a place
in this changing landscape.
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Research support for Justin D. Smith was provided by Research Training Grant
No. MH20012 from the National Institute of Mental Health, awarded to Eliza-
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Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 158 7/22/2013 2:17:56 PM
... Recent conceptualizations of parental mental health encourage moving beyond specific diagnoses to consider transdiagnostic "high-risk" parenting factors (Judd et al., 2018). Mindfulness has been proposed as one such transdiagnostic factor (Maliken & Katz, 2013;Smith & Dishion, 2013) that is strongly related to a number of mental health presentations, as well as parenting attitudes and behaviours (Baer, 2007). It is crucial to better understand modifiable mechanism(s) by which parental mindfulness might relate to children's internalizing symptoms, as these could be targeted through early intervention to disrupt unhelpful developmental trajectories (Yap & Jorm, 2015). ...
... These are then evident in parenting interactions through an awareness of the child's needs and emotions; less reactive discipline, negativity, and disengagement; fundamental acceptance of the child balanced with clear expectations; and ultimately a more positive parent-child relationship, characterized by greater emotional sharing and positive affect. Smith and Dishion's (2013) model highlighted three specific mindful parenting processes: (1) positive behaviour support (e.g. creating and attending to child's positive behaviours), (2) healthy limit setting (including monitoring and supervision), and (3) family relationship building. ...
... A zoomed-in, instancebased approach to coding the verbal content of parent-youth interactions may be ideally placed to answer further questions about the association of mindfulness and observable parenting behaviours. Specifically, is parental mindfulness associated with greater awareness and acceptance of a child's needs, emotions, and traits; greater attention towards a child's positive behaviour; and a capacity to set limits and solve problems adaptively considering others' points of view (Smith & Dishion, 2013). ...
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Objectives Parental mindfulness predicts more positive and supportive parent-child interactions. However, very few studies have tested this association using independent observations of interactions or considered a link with child outcomes. The aims of the current study were to understand (1) how parental mindfulness relates to independent observation of parent-child conflict resolution discussions and (2) how parental mindfulness and conflict resolution relate to children’s symptoms of anxiety and depression.Methods Fifty-seven parents and their 8–12-year-old children were recruited from both clinical and community settings. Dyads engaged in a conflict discussion task from which content and resolution quality were coded. Parents self-reported on their dispositional mindfulness, and children self-reported symptoms of anxiety and depression.ResultsParents who rated themselves as higher in the acting with awareness facet of dispositional mindfulness were more likely to refer to their child’s positive emotions, make more positive (e.g. “you were great”) and less negative (e.g., “it was awful”) evaluations, and made fewer oppositional statements when resolving conflict. Parents who rated themselves as higher in the non-judging facet of mindfulness used more validation during conflict discussions. Mediation bootstrapping models showed support for an indirect path of acting with awareness and observing mindfulness relating to children’s symptoms of anxiety and depression, through positive evaluations. There was also support for an indirect path of observing and describing mindfulness relating to internalizing symptoms through reduced use of oppositional strategies.Conclusions Parent dispositional mindfulness was associated with more positive and supportive conflict resolution discussions. The current findings also provide preliminary support for conflict resolution mediating a relationship between parent dispositional mindfulness and child symptoms of anxiety and depression.
... When resources are abundant and/or cost-effective, one may consider lowering the threshold for outcome identification, particularly if the intervention can be beneficial for all or side effects are benign (Cannon et al., 2016). For instance, strategies for directly improving self-regulation may be beneficial for all children (Smith & Dishion, 2014). Interventions centered on positive parenting in the domains of positive behavior support, monitoring and limit setting, and family relationship building can enhance children's selfregulation, ultimately leading to the prevention of later internalizing and externalizing disorders (Smith & Dishion, 2014). ...
... For instance, strategies for directly improving self-regulation may be beneficial for all children (Smith & Dishion, 2014). Interventions centered on positive parenting in the domains of positive behavior support, monitoring and limit setting, and family relationship building can enhance children's selfregulation, ultimately leading to the prevention of later internalizing and externalizing disorders (Smith & Dishion, 2014). Although the concern of false positives is an important one for reducing burden at the systems level, interventions that improve parenting and/or promote children's self-regulation are likely to be beneficial for all children and families regardless of risk status. ...
The National Institute of Mental Health Research Domain Criteria’s (RDoC) has prompted a paradigm shift from categorical psychiatric disorders to considering multiple levels of vulnerability for probabilistic risk of disorder. However, the lack of neurodevelopmentally-based tools for clinical decision-making has limited RDoC’s real-world impact. Integration with developmental psychopathology principles and statistical methods actualize the clinical implementation of RDoC to inform neurodevelopmental risk. In this conceptual paper, we introduce the probabilistic mental health risk calculator as an innovation for such translation and lay out a research agenda for generating an RDoC- and developmentally-informed paradigm that could be applied to predict a range of developmental psychopathologies from early childhood to young adulthood. We discuss methods that weigh the incremental utility for prediction based on intensity and burden of assessment, the addition of developmental change patterns, considerations for assessing outcomes, and integrative data approaches. Throughout, we illustrate the risk calculator approach with different neurodevelopmental pathways and phenotypes. Finally, we discuss real-world implementation of these methods for improving early identification and prevention of developmental psychopathology. We propose that mental health risk calculators can build a needed bridge between RDoC’s multiple units of analysis and developmental science.
... At last, most studies on parental mindfulness and child development have used samples from the Western world (Calvete et al., 2019;Heapy et al., 2021). However, it has been demonstrated that effective parenting behaviors are profoundly influenced by their culture's unique concepts and values (Smith & Dishion, 2013). As a result, when investigating the meaning and implications of maternal mindfulness and parenting, it is critical to consider the role of culture. ...
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The aim of present study was to explore the possible mediating roles of parenting stress and authoritative parenting style in the relations between maternal mindfulness and children’s social skills among Chinese preschool children. Participants were N = 294 mothers (Mage =34.14 years; SD = 3.79; Range = 25–48 years) and 24 preschool teachers. Upon obtaining consent, mothers completed self-report measures of their dispositional mindfulness, parenting stress and authoritative parenting style. Teachers evaluated each child’s social skills. Among the results, maternal mindfulness was positively associated with children’s social skills. Moreover, bootstrapping revealed a significant indirect effect of maternal mindfulness on children’s social skills via parenting stress and authoritative parenting style. Specifically, maternal mindfulness was related to a low level of parenting stress, which in turn, predicted more authoritative parenting style, and lower level of children’s social skills. This study sheds light on the role of parenting stress and authoritative parenting style in the relationship between maternal mindfulness and children’s social skills.
... Families in the FCU4Health will receive SMS messages via CAMPI to enhance both uptake of intervention content as well as facilitate continued engagement in the program between virtually delivered sessions. Intervention content will be individually tailored to each family's identified needs in parenting practices in the areas of positive behavior support, monitoring and limit setting, and parent-child relationship quality (Smith & Dishion, 2013). SMS messages will contain brief intervention content as well as hyperlinks to lessons and additional content in the form of live-action and animated videos, infographics, storyboards, and so forth. ...
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Introduction: Short message service (SMS) is a widely accepted telecommunications approach used to support health informatics, including behavioral interventions, data collection, and patient-provider communication. However, SMS delivery platforms are not standardized and platforms are typically commercial "off-the-shelf" or developed "in-house." As a consequence of platform variability, implementing SMS-based interventions may be challenging for both providers and patients. Off-the-shelf SMS delivery platforms may require minimal development or technical resources from providers, but users are often limited in their functionality. Conversely, platforms that are developed in-house are often specified for individual projects, requiring specialized development and technical expertise. Patients are on the receiving end of programming and technical specification challenges; message delays or lagged data affect quality of SMS communications. To date, little work has been done to develop a generalizable SMS platform that can be scaled across health initiatives. Objective: We propose the Configurable Assessment Messaging Platform for Interventions (CAMPI) to mitigate challenges associated with SMS intervention implementation (e.g., programming, data collection, message delivery). Method: CAMPI aims to optimize health data captured from a multitude of sources and enhance patient-provider communication through a technology that is simple and familiar to patients. Using representative examples from three behavioral intervention case studies implemented among diverse populations (pregnant women, young sexual minority men, and parents with young children), we describe CAMPI capabilities and feasibility. Conclusion: As a generalizable SMS platform, CAMPI can be scaled to meet the priorities of various health initiatives, while reducing unnecessary resource utilization and burden on providers and patients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... In contrast to BPT programs, that primarily target regulation of parenting behavior, mindful parenting training primarily targets regulation of parenting stress and other emotions. As such, mindful parenting training fosters parent awareness and acceptance of the emotional reactions of their child and themselves, which allows parents to interrupt their automatic behavioral reactions to challenging parenting situations (Bögels et al. 2010;Duncan et al. 2009;Smith and Dishion 2013). This process has been referred to as "parenting from the inside out" (Siegel and Hartzell 2013). ...
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As a clinical intervention, Mindful Parenting has positive effects on parental stress and psychopathology, as well as child psychopathology. However, previous studies have not considered what characterizes parents and families who receive this type of intervention. The current study utilized a quasi-experimental design to determine the characteristics that distinguish parents seeking or referred to a mindful parenting intervention in community child mental health care centers. Two groups of parents were recruited to the study: treatment-seeking parents (n = 89), and a comparison group of parents from a community population (n = 66). All parents completed measures relating to their child’s psychopathology, their own psychopathology, general mindful awareness, and parenting measures of stress, over-reactivity, experiential avoidance and mindful parenting. A cross-sectional comparison confirmed that the treatment-seeking parents reported significantly higher psychopathology in their child (d = 0.91–1.19) and in themselves (d = 0.99–1.21), lower general mindful awareness, and higher parenting stress, over-reactivity, parental experiential avoidance and lower mindful parenting than the community parents. Across all outcomes, group differences in mindful parenting indicated the largest effect (d = 1.77), followed by parenting stress (d = 1.42), general mindfulness (d = 1.34), parental over-reactivity (d = 1.32), and parental experiential avoidance (d = 1.21). Hierarchical binary logistic regression analyses indicated that, next to higher child internalizing problems, lower mindful parenting distinguished treatment-seeking parents from community parents. Those parents seeking or referred to a mindful parenting intervention may benefit most from improvements in the very construct that the intervention targets: cultivating mindful parenting.
... For instance, the prominent links between broadband positive/negative parenting and children's externalizing/internalizing problems have been verified among early childhood (3-7 years old), middle childhood (8-12 years old), and adolescence (13-17 years old) (e.g., Parent & Forehand, 2017;Riley et al., 2019). Given the assumption that parenting norms vary across cultures (Leung et al., 1998;Smith & Dishion, 2013), it is necessary to explore the reliability and validity of the MAPS among parents in countries outside of the United States (U.S.)-both as a means of accurately assessing parenting practices across cultures and of facilitating cross-cultural research on parenting and child development. ...
Parenting practices have been linked to a wide range of issues related to children's psychological adjustment; however, more research is warranted to further understand not only cultural variations of parenting norms, but also how such variations might differentially influence child outcomes. The current study examined the psychometric properties of a Chinese translation of the Multidimensional Assessment of Parenting Scale (MAPS) in order to: (a) assess both positive and negative dimensions of parenting in Chinese-speaking societies and (b) to explore the association between these practices and children's psychopathological symptoms. A total of 2,237 parents with children between 6 and 12 years old completed the MAPS, Interpersonal Mindfulness in Parenting Scale (IM-P), adapted Parental Bonding Instrument (PBI), and other measures related to children's psychosocial functioning. Exploratory and confirmatory factor analyses (CFA) revealed a clear six-factor structure. Strong to strict measurement invariance for child gender, parent gender, and child age were found. The results demonstrated adequate psychometric properties in terms of internal consistency and test-retest reliability. MAPS subscales also showed concurrent and convergent validity with mindful parenting, parent-child bonding, and children's psychopathology outcomes. The Chinese version of the MAPS will help facilitate multidimensional parenting research in Chinese-speaking societies and promote future cross-cultural studies examining the effect of positive and negative parenting on children's psychopathological adjustment. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... For instance, the prominent links between broadband positive/negative parenting and children's externalizing/internalizing problems have been verified among early childhood (3-7 years old), middle childhood (8-12 years old), and adolescence (13-17 years old) (e.g., Parent & Forehand, 2017;Riley et al., 2019). Given the assumption that parenting norms vary across cultures (Leung et al., 1998;Smith & Dishion, 2013), it is necessary to explore the reliability and validity of the MAPS among parents in countries outside of the United States (U.S.)-both as a means of accurately assessing parenting practices across cultures and of facilitating cross-cultural research on parenting and child development. ...
Parenting practices have been linked to a wide range of issues related to children’s psychological adjustment; however, more research is warranted to further understand not only cultural variations of parenting norms, but also how such variations might differentially influence child outcomes. The current study examined the psychometric properties of a Chinese translation of the Multidimensional Assessment of Parenting Scale (MAPS) in order to: 1) assess both positive and negative dimensions of parenting in Chinese-speaking societies, and 2) to explore the relationships between these practices and children’s psychopathological symptoms. A total of 2237 parents with children between 6-12 years old completed the MAPS, Interpersonal Mindfulness in Parenting Scale (IM-P), adapted Parental Bonding Instrument (PBI), and other measures related to children’s psychosocial functioning. Exploratory and confirmatory factor analyses revealed a clear six-factor structure. Results demonstrated adequate psychometric properties in terms of internal consistency and test-retest reliability. MAPS subscales also showed concurrent and convergent validity with mindful parenting, parent-child bonding, and children’s psychopathology outcomes. The importance of using culturally validated dimensional measures of parenting is discussed in this paper.
... Parenting programs, especially parent training programs, target core caregiver skills that help children gain self-regulatory capacity. Smith and Dishion (2013) provide a summary of the evidence for the transdiagnostic effects of parent training interventions and argue that improving caregiver skills in three areas-positive behavior support, monitoring and limit setting, and family relationship building-lead to improved regulation Table 3. All covariates at bottom of figure were assessed at study entry (child age 2). ...
Building on prior work using Tom Dishion's Family Check-Up, the current article examined intervention effects on dysregulated irritability in early childhood. Dysregulated irritability, defined as reactive and intense response to frustration, and prolonged angry mood, is an ideal marker of neurodevelopmental vulnerability to later psychopathology because it is a transdiagnostic indicator of decrements in self-regulation that are measurable in the first years of life that have lifelong implications for health and disease. This study is perhaps the first randomized trial to examine the direct effects of an evidence- and family-based intervention, the Family Check-Up (FCU), on irritability in early childhood and the effects of reductions in irritability on later risk of child internalizing and externalizing symptomatology. Data from the geographically and sociodemographically diverse multisite Early Steps randomized prevention trial were used. Path modeling revealed intervention effects on irritability at age 4, which predicted lower externalizing and internalizing symptoms at age 10.5. Results indicate that family-based programs initiated in early childhood can reduce early childhood irritability and later risk for psychopathology. This holds promise for earlier identification and prevention approaches that target transdiagnostic pathways. Implications for future basic and prevention research are discussed.
... As an extension of mindful awareness, mindful parenting is understood to be the awareness of present-moment parenting experience. Current definitions of the construct include the parent's efforts to self-regulate emotional and automatic reactions in the parenting context, in order to respond through choice in their actions rather than from emotional reactivity (Duncan et al. 2009;Smith and Dishion 2013). This capacity for self-regulation has been proposed to help parents to be less over-reactive and to parent in accordance with their parenting goals (Gouveia et al. 2016). ...
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Objectives Emerging evidence supports the positive effects of mindful parenting as a clinical intervention in the context of child psychopathology; however, previous studies have not considered the specific parenting predictors of improvements in child outcomes. Methods Parents accessing a child and youth secondary mental health care center participated in an 8-week mindful parenting training (n = 89). The effects of the mindful parenting training were assessed on parent-reported child’s psychopathology, parents’ own psychopathology, mindfulness, and parenting factors from pre- to post-intervention, 8-week and 1-year follow-up. Results Multi-level analyses indicated immediate and delayed improvements in most child and parent outcomes. Changes in experiential avoidance in parenting partially predicted improvements in child internalizing problems. In combination with mindful parenting, experiential avoidance in parenting fully accounted for improvements in child attention problems. Changes in parental over-reactivity fully accounted for improvements in child externalizing problems. Conclusions The mindful parenting training successfully improved the targeted (mindful) parenting factors, which in turn predicted improvements across different child outcomes.
Mindful parenting is linked to positive youth emotion regulation, mental health, and parent-child relationship quality. We examined bidirectional relations between adolescent mental health and mindful parenting among a diverse sample of 249 7th grade students and their female (N = 232) and male caregivers (N = 120). We conducted multiple-group cross-lagged models (grouped by adolescent sex). Female adolescents' externalizing symptoms predicted decreased female caregiver mindful parenting six months later, but male and female adolescent externalizing behaviors were negatively associated with male caregivers' mindful parenting one year later. Findings suggest mindful parenting capacities are vulnerable to disruption via adolescent problem behavior. Mindful parenting's potential benefits, caveats, and need to support parent efforts to sustain mindful parenting amidst adolescents' externalizing behaviors are discussed.
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Interest in applications of mindfulness-based approaches with adults has grown rapidly in recent times, and there is an expanding research base that suggests these are efficacious approaches to promoting psychological health and well-being. Interest has spread to applications of mindfulness-based approaches with children and adolescents, yet the research is still in its infancy. I aim to provide a preliminary review of the current research base of mindfulness-based approaches with children and adolescents, focusing on MBSR/MBCT models, which place the regular practice of mindfulness meditation at the core of the intervention. Overall, the current research base provides support for the feasibility of mindfulness-based interventions with children and adolescents, however there is no generalized empirical evidence of the efficacy of these interventions. For the field to advance, I suggest that research needs to shift away from feasibility studies towards large, well-designed studies with robust methodologies, and adopt standardized formats for interventions, allowing for replication and comparison studies, to develop a firm research evidence base. KeywordsMindfulness meditation-Children-Adolescents-Families-Schools
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Seven hundred thirty-one income-eligible families in 3 geographical regions who were enrolled in a national food supplement program were screened and randomized to a brief family intervention. At child ages 2 and 3, the intervention group caregivers were offered the Family Check-Up and linked parenting support services. Latent growth models on caregiver reports at child ages 2, 3, and 4 revealed decreased behavior problems when compared with the control group. Intervention effects occurred predominantly among families reporting high levels of problem behavior at child age 2. Families in the intervention condition improved on direct observation measures of caregivers' positive behavior support at child ages 2 and 3; improvements in positive behavior support mediated improvements in children's early problem behavior.
This chapter discusses the possible role of self-regulation in the development of antisocial behavior. Consistent with a social interaction perspective, the authors assume that self-regulation is highly embedded in relationship dynamics, consisting of a set of behaviors such as turn taking and listening to others. Self-regulation is the most promising candidate for linking individual characteristics to the ecology in a way that will be helpful in understanding the development of antisocial behavior. The chapter describes the complementary hypothesis that the social interactions within a gang, replete with mutual identification, account for the influence of gangs on problem behavior. A repeating theme in the chapter, and in developmental psychopathology in general, is the synergistic relationship between intervention research and developmental research. The chapter uses a mesosystem model that incorporates both parenting practices and peer influences to explain the persistence and continuance of antisocial behavior into adulthood.
Completely up-to-date, this engaging and practice-oriented text is your complete resource to help students master the many facets of family therapy. In this ninth edition, the authors provide practice-oriented content in a more concise format that will help students become empathic and effective family therapists. New material focuses on how students can practice systemic thinking and on how to develop core competencies in family therapy. There is also increased attention to LGBTQ families and alternative forms of family life, and to gender, culture, and ethnic considerations. Color-coded boxes highlight key aspects of family therapy, such as family diversity, evidence-based practice research, "Thinking Like a Clinician" student exercises, case studies, clinical notes, and therapeutic encounters. Examples illustrate family therapists from many professions, including social work, MFT, psychology, and counseling. Learning objectives focus students' attention on key concepts.
The mechanisms through which multisystemic therapy (MST) decreased delinquent behavior were assessed in 2 samples of juvenile offenders. Sample 1 included serious offenders who were predominantly rural, male, and African American. Sample 2 included substance-abusing offenders who were predominantly urban, male, and Caucasian. Therapist adherence to the MST protocol (based on multiple respondents) was associated with improved family relations (family cohesion, family functioning, and parent monitoring) and decreased delinquent peer affiliation, which, in turn, were associated with decreased delinquent behavior. Furthermore, changes in family relations and delinquent peer affiliation mediated the relationship between caregiver-rated adherence and reductions in delinquent behavior. The findings highlight the importance of identifying central change mechanisms in determining how complex treatments such as MST contribute to ultimate outcomes.
This study examined parenting practices and adolescent depressive symptoms among Chinese Americans. First, confirmatory factor analyses revealed that self-reported parenting practices by mothers and fathers and adolescent perception of parenting practices loaded adequately on three subscales: Inductive Reasoning, Monitoring, and Harsh Discipline. Second, parents' depressive symptoms were related to disrupted parenting practices, which, in turn, were significantly related to the negative evaluation of these behaviors by the adolescents. Adolescents' perceptions of such parenting practices were significantly associated with their depressive symptoms. Third, the relationships were robust even after parental income, education, and generation status were statistically controlled. Overall, the relationships between parenting practices and adolescent depressive symptoms among Chinese Americans seemed to echo those found among European Americans.
Research in applied behavior analysis has shaped an important technology, called functional assessment, for understanding the relationship between problem behavior and environmental events and factors. From this understanding, effective and relevant behavioral interventions have emerged. However, given the dramatic increase in the need to conduct functional assessments, efforts must focus on translating what we have learned from this research into formats and processes that can be used efficiently in applied settings. In addition, research must continue to build a technology of functional assessment that meets the full range of situations faced in our schools, homes, and communities.