Content uploaded by J.D. Smith
Author content
All content in this area was uploaded by J.D. Smith on Jan 07, 2014
Content may be subject to copyright.
138
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.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 138 7/22/2013 2:17:55 PM
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.
Family
Relationship
Building
Parents’ Healthy
Limit Setting
Positive
Behavior
Support
Family
Functioning
Internalizing
Disorders
Disruptive
Behavior
Disorders
Mindful
Parenting
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 139 7/22/2013 2:17:55 PM
140 TRANSDIAGNOSTIC PROCESSES
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
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 140 7/22/2013 2:17:55 PM
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.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 141 7/22/2013 2:17:55 PM
142 TRANSDIAGNOSTIC PROCESSES
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
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 142 7/22/2013 2:17:55 PM
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,
2003).
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
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 143 7/22/2013 2:17:55 PM
144 TRANSDIAGNOSTIC PROCESSES
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
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 144 7/22/2013 2:17:55 PM
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
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 145 7/22/2013 2:17:55 PM
146 TRANSDIAGNOSTIC PROCESSES
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
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 146 7/22/2013 2:17:55 PM
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
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 147 7/22/2013 2:17:55 PM
148 TRANSDIAGNOSTIC PROCESSES
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.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 148 7/22/2013 2:17:55 PM
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.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 149 7/22/2013 2:17:55 PM
150 TRANSDIAGNOSTIC PROCESSES
ACKNOWLEDGMENTS
Research support for Justin D. Smith was provided by Research Training Grant
No. MH20012 from the National Institute of Mental Health, awarded to Eliza-
beth Stormshak. Research support for Thomas J. Dishion was provided by Grant
No. DA07031 from the National Institute on Drug Abuse. We gratefully acknowl-
edge Cheryl Mikkola for her editorial support.
REFERENCES
Ainsworth, M. S. (1989). Attachments beyond infancy. American Psychologist, 44,
709–716.
Aldao, A., Nolen- Hoeksema, S., & Schweizer, S. (2010). Emotion- regulation strat-
egies across psychopathology: A meta- analytic review. Clinical Psychology
Review, 30, 217–237.
Alloy, L. B., Abramson, L. Y., Smith, J. M., Gibb, B. E., & Neeren, A. M. (2006).
Role of parenting and maltreatment histories in unipolar and bipolar mood
disorders: Mediation by cognitive vulnerability to depression. Clinical Child
and Family Psychology Review, 9, 23–64.
Amodio, D. M. (2011). Self- regulation in intergroup relations: A social neu-
roscience framework. In A. Todorov, S. T. Fiske, & D. A. Prentice (Eds.),
Social neuroscience: Toward understanding the underpinning of the social mind
(pp. 101–122). Oxford, UK: Oxford University Press.
Asarnow, R. F., & Kernan, C. L. (2008). Childhood schizophrenia. In T. P. Beau-
chaine & S. P. Hinshaw (Eds.), Child and adolescent psychopathology (pp. 614–
642). New York: Wiley.
Bank, L., Burraston, B., & Snyder, J. (2004). Sibling conf lict and ineffective par-
enting as predictors of adolescent boys’ antisocial behavior and peer diffi-
culties: Additive and interactional effects. Journal of Research on Adolescence,
14, 99 –125.
Bargh, J. A., & Williams, E. L. (2006). The automaticity of social life. Current
Directions in Psychological Science, 15, 1–4.
Barlow, J., & Stewart- Brown, S. (2000). Behavior problems and group-based par-
ent education programs. Journal of Developmental and Behavioral Pediatrics,
21, 356–370.
Barnes, S., Brown, K. W., Krusemark, E., Campbell, W. K., & Rogge, R. D. (2007).
The role of mindfulness in romantic relationship satisfaction and responses
to relationship stress. Journal of Marital and Family Therapy, 33, 482–500.
Beach, S. R. H., Wamboldt, M. Z., Kaslow, N. J., Heyman, R. E., First, M. B.,
Underwood, L. G., et al. (Eds.). (2006). Relational processes and DSM-V: Neu-
roscience, assessment, prevention, and treatment. Washington, DC: American
Psychiatric Association.
Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: Sadness and depression. New
York: Basic Books.
Brody, G. H. (2003). Parental monitoring: Action and reaction. Mahwah, NJ: Erl-
baum.
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 150 7/22/2013 2:17:55 PM
Mindful Parenting 151
and its role in psychological well-being. Journal of Personality and Social Psy-
chology, 84, 822–848.
Burke, C. A. (2010). Mindfulness- based approaches with children and adoles-
cents: A preliminary review of current research in an emergent field. Journal
of Child and Family Studies, 19, 133–144.
Burke, J. D., Loeber, R., & Birmaher, B. (2002). Oppositional defiant and conduct
disorder: A review of the past 10 years. Part II. Journal of the American Acad-
emy of Child and Adolescent Psychiatry, 41, 1275–1293.
Campbell, T. L., & Patterson, J. M. (1995). The effectiveness of family interven-
tions in the treatment of physical illness. Journal of Marital and Family Ther-
ap y, 21, 545–584.
Caruthers, A. J., Van Ryzin, M. J., & Dishion, T. J. (in press). Preventing high-risk
sexual behavior in early adulthood with family interventions in adolescence:
Outcomes and developmental processes. Prevention Science.
Cheron, D. M., Ehrenreich, J. T., & Pincus, D. (2009). Assessment of parental
experiential avoidance in a clinical sample of children with anxiety disor-
ders. Child Psychiatr y and Human Development, 40, 383–403.
Chilcoat, H. D., & Anthony, J. C. (1996). Impact of parent monitoring on initia-
tion of drug use through late childhood. Journal of the American Academy of
Child and Adolescent Psychiatry, 35, 91–100.
Chu, B. C. (2012). Translating transdiagnostic approaches to children and adoles-
cents. Cognitive and Behavioral Practice, 19, 1–4
Cicchetti, D. V. (1993). Developmental psychopathology: Reactions, reflections,
projections. Developmental Review, 13, 471–502.
Cicchetti, D. V. (2008). Multi-level analysis perspective on research and develop-
ment and psychopathology. In T. P. Beauchaine & S. P. Hinshaw (Eds.), Child
and adolescent psychopathology (pp. 27–57). New York: Wiley.
Cicchetti, D. V., & Toth, S. L. (1998). The development of depression in children
and adolescents. American Psychologist, 53, 221–241.
Coatsworth, J. D., Duncan, L., Greenberg, M., & Nix, R. (2010). Changing par-
ent’s mindfulness, child management skills and relationship quality with
their youth: Results from a randomized pilot intervention trial. Journal of
Child and Family Studies, 19, 203–217.
Cohen, J. A. S., & Semple, R. J. (2010). Mindful parenting: A call for research.
Journal of Child and Family Studies, 19, 145–151.
Compton, S. N., March, J. S., Brent, D., Albano, A. M., Weersing, V. R., & Curry,
J. (2004). Cognitive- behavioral psychotherapy for anxiety and depressive
disorders in children and adolescents: An evidence- based medicine review.
Journal of the American Academy of Child and Adolescent Psychiatry, 43, 930–959.
Connell, A. M., & Dishion, T. J. (2008). Reducing depression among at-risk early
adolescents: Three-year effects of a family- centered intervention embedded
within schools. Journal of Family Psychology, 22, 574 –585.
Connor, D. F. (2002). Aggression and antisocial behavior in children and adolescents:
Research and treatment. New York: Guilford Press.
Crowell, S. E., Kaufman, E. A., & Lenzenweger, M. F. (2013). The development
of borderline personality disorder and self- inflicted injury. In T. P. Beau-
chaine & S. P. Hinshaw (Eds.), Child and adolescent psychopathology (2nd ed.,
pp. 577–609). Hoboken, NJ: Wiley.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 151 7/22/2013 2:17:55 PM
152 TRANSDIAGNOSTIC PROCESSES
Cummings, E. M., Davies, P. T., & Campbell, S. B. (2000). Developmental psychopa-
thology and family process: Theory, research, and clinical implications. New York:
Guilford Press.
Diamond, G. S., & Josephson, A. (2005). Family-based treatment research: A
10-year update. Journal of the American Academy of Child and Adolescent Psy-
chiatry, 44, 872–887.
DiClemente, R. J., Wingood, G. M., Crosby, R., Sionean, C., Cobb, B. K., Har-
rington, K., et al. (2001). Parental monitoring: Association with adolescents’
risk behaviors. Pediatrics, 107, 1363–1368.
Dishion, T. J., Burraston, B., & Li, F. (2003). Family management practices:
Research design and measurement issues. In Z. Sloboda & W. J. Bukoski
(Eds.), Handbook for drug abuse prevention: Theory, science, and practice
(pp. 587–607). New York: Plenum Press.
Dishion, T. J., Capaldi, D. M., & Yoerger, K. (1999). Middle childhood anteced-
ents to progression in male adolescent substance use: An ecological analysis
of risk and protection. Journal of Adolescent Research, 14, 175–205.
Dishion, T. J., & McMahon, R. J. (1998). Parental monitoring and the prevention
of child and adolescent problem behavior: A conceptual and empirical for-
mulation. Clinical Child and Family Psycholog y Review, 1, 61–75.
Dishion, T. J., Nelson, S. E., & Bullock, B. M. (2004). Premature adolescent auton-
omy: Parent disengagement and deviant peer process in the amplification of
problem behavior. Journal of Adolescence, 27, 515–530.
Dishion, T. J., Nelson, S. E., & Kavanagh, K. (2003). The Family Check-Up for
high-risk adolescents: Preventing early-onset substance use by parent moni-
toring. Behavior Therapy, 34, 553–571.
Dishion, T. J., & Patterson, G. R. (1999). Model- building in developmental psy-
chopathology: A pragmatic approach to understanding and intervention.
Journal of Clinical Child Psychology, 28, 502–512 .
Dishion, T. J., & Patterson, G. R. (2006). The development and ecology of anti-
social behavior in children and adolescents. In D. Cicchetti & D. J. Cohen
(Eds.), Developmental psychopathology: Vol. 3. Risk, disorder, and adaptation
(pp. 503–541). Hoboken, NJ: Wiley.
Dishion, T. J., Patterson, G. R., & Kavanaugh, K. (1992). An experimental test
of the coercion model: Linking theory, measurement, and intervention. In
J. McCord & R. Tremblay (Eds.), Preventing antisocial behavior: Interventions
from birth through adolescence (pp. 253–282). New York: Guilford Press.
Dishion, T. J., Shaw, D. S., Connell, A., Gardner, F. E. M., Weaver, C., & Wilson, M.
(2008). The Family Check-Up with high-risk indigent families: Preventing
problem behavior by increasing parents’ positive behavior support in early
childhood. Child Development, 79, 1395–1414.
Dishion, T. J., & Stormshak, E. A. (2007). Intervening in children’s lives: An ecologi-
cal, family- centered approach to mental health care. Washington, DC: American
Psychological Association.
Dishion, T. J., Stormshak, E. A., & Kavanagh, K. (2012). Everyday parenting: A pro-
fessional’s guide to building family management skills. Champaign, IL: Research
Press.
Doane, J., Goldstein, M. J., Miklowitz, D. J., & Falloon, I. R. H. (1986). The impact
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 152 7/22/2013 2:17:55 PM
Mindful Parenting 153
of individual and family treatment on the affective climate of families of
schizophrenics. British Journal of Psychiatry, 148, 279 –287.
Du Rocher Schudlich, T., Youngstrom, E., Calabrese, J., & Findling, R. (2008).
The role of family functioning in bipolar disorder in families. Journal of
Abnormal Child Psycholog y, 36, 849–863.
Dumas, J. E. (2005). Mindfulness- based parent training: Strategies to lessen the
grip of automaticity in families with disruptive children. Journal of Clinical
Child and Adolescent Psychology, 34, 779–791.
Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009). A model of mind-
ful parenting: Implications for parent– child relationships and prevention
research. Clinical Child and Family Psycholog y Review, 12, 255–270.
Falloon, I. R., Boyd, J. L., McGill, C. W., Williamson, M., Razani, J., Moss, H. B., et
al. (1985). Family management in the prevention of morbidity of schizophre-
nia: Clinical outcome of a two-year longitudinal study. Archives of General
Psychiatr y, 42, 887–896.
Forgatch, M. S. (1989). Patterns and outcome in family problem solving: The
disrupting effect of negative emotion. Journal of Marriage and the Family, 51,
115–124.
Fosco, G. M., Stormshak, E. A., Dishion, T. J., & Winter, C. (2012). Family rela-
tionships and parental monitoring during middle school as predictors of
early adolescent problem behavior. Journal of Clinical Child and Adolescent
Psychology, 41, 202–213.
Frick, P. J., & Loney, B. R. (2002). Understanding the association between parent
and child antisocial behavior. In R. J. McMahon & R. D. Peters (Eds.), The
effects of parental dysfunction on children (pp. 105–126). New York: Plenum
Press.
Garber, J., Robinson, N. S., & Valentiner, D. (1997). The relation between parent-
ing and adolescent depression: Self-worth as a mediator. Journal of Adolescent
Research, 12, 12–33.
Garcia, M., Shaw, D. S., Winslow, E. B., & Yaggi, K. (2000). Destructive sibling
conflict and the development of conduct problems in young boys. Develop-
mental Psychology, 36, 44–53.
Gardner, F. E. M. (1987). Positive interaction between mothers and conduct-
problem children: Is there training for harmony as well as fighting? Journal
of Abnormal Child Psychology, 15, 283–293.
Gardner, F. E. M., Burton, J., & Klimes, I. (2006). Randomised controlled trial of
a parenting intervention in the voluntary sector for reducing child conduct
problems: Outcomes and mechanisms of change. Journal of Child Psychology
and Psychiatry, 47, 1123 –1132.
Gardner, F. E. M., Shaw, D. S., Dishion, T. J., Burton, J., & Supplee, L. (2007).
Randomised prevention trial for early conduct problems: Effects on pro-
active parenting and links to toddler disruptive behavior. Journal of Family
Psychology, 21, 398–406.
Gardner, F. E. M., Sonuga-Barke, E., & Sayal, K. (1999). Parents anticipating
misbehaviour: An observational study of strategies parents use to prevent
conflict with behaviour problem children. Journal of Child Psychology and Psy-
chiatry, 40, 1184 –1196.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 153 7/22/2013 2:17:56 PM
154 TRANSDIAGNOSTIC PROCESSES
Gardner, F. E. M., Ward, S., Burton, J., & Wilson, C. (2003). The role of mother–
child joint play in the early development of children’s conduct problems: A
longitudinal observational study. Social Development, 12, 361–379.
Ge, X., Best, K. M., Conger, R. D., & Simons, R. L. (1996). Parenting behaviors
and the occurrence and co- occurrence of adolescent depressive symptoms
and conduct problems. Developmental Psychology, 32, 717–731.
Geller, B., Craney, J. L., Bolhofner, K., Nickelsburg, M. J., Williams, M., & Zimer-
man, B. (2002). Two-year prospective follow- up of children with a prepu-
bertal and early adolescent bipolar disorder phenotype. American Journal of
Psychiatry, 159, 927–933.
Ginsburg, G. S., & Schlossberg, M. (2002). Family-based treatment of childhood
anxiety disorders. International Review of Psychiatry, 14, 143–154.
Goodman, S. H., & Gotlib, I. H. (1999). Risk for psychopathology in the children
of depressed mothers: A developmental model for understanding mecha-
nisms of transmission. Psychological Review, 106, 458–490.
Grusec, J. E., & Goodnow, J. J. (1994). Impact of parental discipline methods on
child’s internalization of values: A reconceptualization of current points of
view. Developmental Psychology, 30, 4–19.
Henggeler, S. W., & Borduin, C. M. (1990). Family therapy and beyond: A multi-
systemic approach to treating the behavior problems of children and adolescents.
Pacific Grove, CA: Brooks/Cole.
Hoffman, L. W. (1991). The influence of the family environment on personality:
Accounting for sibling differences. Psychological Bulletin, 110, 187–203.
Horner, R. H., & Carr, E. G. (1997). Behavioral support for students with severe
disabilities: Functional assessment and comprehensive intervention. Journal
of Special Education, 31, 84 –10 9.
Huey, S. J., Jr., Henggeler, S. W., Brondino, M. J., & Pickrel, S. G. (2000). Mecha-
nisms of change in multisystemic therapy: Reducing delinquent behavior
through therapist adherence and improved family and peer functioning.
Journal of Consulting and Clinical Psychology, 68, 451–467.
Johnston, C., & Mash, E. J. (2001). Families of children with attention- deficit/
hyperactivity disorder: Review and recommendations for future research.
Clinical Child and Family Psycholog y Review, 4, 183 –207.
Kabat-Zinn, J. (2003). Mindfulness- based interventions in context: Past, present,
and future. Clinical Psychology: Science and Practice, 10, 144 –156 .
Kabat-Zinn, M., & Kabat-Zinn, J. (1997). Everyday blessings: The inner work of mind-
ful parenting. New York: Hyperion.
Kashdan, T. B., Jacob, R., Pelham, W., Lang, A. R., Hoza, B., Blumenthal, J. D.,
et al. (2004). Depression and anxiety in parents of children with ADHD
and varying levels of oppositional defiant behaviors: Modeling relationships
with family functioning. Journal of Clinical Child and Adolescent Psychology,
33, 169 –181.
Kazdin, A. E. (2005). Treatment outcomes, common factors, and continued
neglect of mechanisms of change. Clinical Psychology: Science and Practice,
12, 184–188.
Kazdin, A. E., & Nock, M. K. (2003). Delineating mechanisms of change in child
and adolescent therapy: Methodological issues and research recommenda-
tions. Journal of Child Psychology and Psychiatry, 44, 1116 –1129.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 154 7/22/2013 2:17:56 PM
Mindful Parenting 155
Kerr, M., & Stattin, H. (2000). What parents know, how they know it, and several
forms of adolescent adjustment: Further support for a reinterpretation of
monitoring. Developmental Psychology, 36, 366–380.
Kiesner, J., Poulin, F., & Dishion, T. J. (2010). Adolescent substance use with
friends: Moderating and mediating effects of parental monitoring and peer
activity contexts. Merrill- Palmer Quarterly, 56, 529–556.
Kim, S. Y., & Ge, X. (2000). Parenting practices and adolescent depressive symp-
toms in Chinese American families. Journal of Family Psychology, 14, 420–
435.
Kochanska, G. (2002). Committed compliance, moral self, and internalization: A
mediational model. Developmental Psychology, 38, 339–351.
Lac, A., & Crano, W. D. (2009). Monitoring matters: Meta- analytic review reveals
the reliable linkage of parent monitoring with adolescent marijuana use.
Perspectives on Psychological Science, 4, 578–586.
Laird, R. D., Criss, M. M., Pettit, G. S., Dodge, K. A., & Bates, J. E. (2008). Par-
ents monitoring knowledge attenuates the link between antisocial friends
and adolescent delinquent behavior. Journal of Abnormal Child Psychology, 36,
299–310.
Lee, J., Semple, R. J., Rosa, D., & Miller, L. (2008). Mindfulness- based cognitive
therapy for children: Results of a pilot study. Journal of Cognitive Psychother-
apy, 22, 15–28.
Liddle, H. A. (2004). Family-based therapies for adolescent alcohol and drug use:
Research contributions and future research needs. Addiction, 99, 76–92.
Liddle, H. A., & Dakof, G. (1995). Family-based treatment for adolescent drug
use: State of the science. In E. Rahdert & D. Czechowicz (Eds.), Adolescent
drug abuse: Clinical assessment and therapeutic interventions (NIDA Research
Monograph). Rockville, MD: National Institute on Drug Abuse.
Lindahl, K. M. (1998). Family process variables and children’s disruptive behav-
ior problems. Journal of Family Psychology, 12, 420–436.
Loeber, R., Burke, J. D., & Pardini, D. A. (2009). Perspectives on oppositional
defiant disorder, conduct disorder, and psychopathic features. Journal of
Child Psychology and Psychiatry, 50, 133–142.
Lunkenheimer, E. S., Dishion, T. J., Shaw, D. S., Connell, A. M., Gardner, F. E. M.,
Wilson, M. N., et al. (2008). Collateral benefits of the Family Check-Up on
early childhood school readiness: Indirect effects of parents’ positive behav-
ior support. Developmental Psychology, 44, 1737–1752.
Mann, B. J., Borduin, C. M., Henggeler, S. W., & Blaske, D. M. (1990). An investi-
gation of systemic conceptualizations of parent– child coalitions and symp-
tom change. Journal of Consulting and Clinical Psychology, 58, 336–344.
McFarlane, W. R., Dixon, L., Lukens, E., & Lucksted, A. (2002). Severe mental
illness. In D. H. Sprenkle (Ed.), Effectiveness research in marriage and family
therapy (pp. 255–298). Alexandria, VA: American Association for Marriage
and Family Therapy.
Pardini, D. A. (2008). Empirically supported treatments for conduct disorders in
children and adolescents. In J. A. Trafton & W. Gordon (Eds.), Best practices
in the behavioral management of disorders of infancy, childhood and adolescence
(pp. 290–321). Los Altos, CA: Institute for Brain Potential.
Patterson, G. R. (1982). Coercive family process. Eugene, OR: Castalia.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 155 7/22/2013 2:17:56 PM
156 TRANSDIAGNOSTIC PROCESSES
Patterson, G. R., Reid, J. B., & Dishion, T. J. (1992). Antisocial boys. Eugene, OR:
Castalia.
Patterson, G. R., & Stouthamer- Loeber, M. (1984). The correlation of family man-
agement practices and delinquency. Child Development, 55, 12 99–1307.
Pelham, W. E., Wheeler, T., & Chronis, A. (1998). Empirically supported psycho-
social treatments for attention deficit hyperactivity disorder. Journal of Clini-
cal Child Psycholog y, 27, 190–205.
Pharoah, F. M., Mari, J. J., Rathbone, J., & Wong, W. (2010). Family intervention
for schizophrenia. Cochrane Database of Systematic Reviews, Issue 2 (Article
No. CD000088).
Pinsof, W. M., & Wynne, L. C. (2000). Toward progress research: Closing the gap
between family therapy practice and research. Journal of Marital and Family
Therapy, 26, 1–8.
Posner, M. I., & Rothbart, M. K. (200 0). Developing mechanisms of self- regulation.
Development and Psychopathology, 12, 427–441.
Radke- Yarrow, M., Ricters, J., & Wilson, W. E. (1988). Child development in a
network of relationships. In R. Hinde & J. Stevenson- Hinde (Eds.), Individu-
als in a network of relationships (pp. 48–67). Cambridge, UK: Cambridge Uni-
versity Press.
Repetti, R. L., Taylor, S. E., & Seeman, T. E. (2002). Risky families: Family social
environments and the mental and physical health of offspring. Psychological
Bulletin, 128, 330–366.
Restifo, K., & Bogels, S. (2009). Family processes in the development of youth
depression: Translating the evidence to treatment. Clinical Psychology Review,
29, 294 –316.
Rubin, K. H., Burgess, K. B., Dwyer, K. M., & Hastings, P. D. (2003). Predicting
preschoolers’ externalizing behaviors from toddler temperament, conflict,
and maternal negativity. Developmental Psychology, 39, 164–176.
Rutter, M. (2006). Genes and behavior: Nature– nurture interplay explained. Malden,
MA: Blackwell.
Sander, J. B., & McCarty, C. A. (2005). Youth depression in the family context:
Familial risk factors and models of treatment. Clinical Child and Family Psy-
chology Review, 8, 203–219.
Shaw, D. S., Connell, A., Dishion, T. J., Wilson, M. N., & Gardner, F. E. M. (2009).
Improvements in maternal depression as a mediator of intervention effects
on early childhood problem behavior. Development and Psychopathology, 21,
417– 439.
Shaw, D. S., & Gross, H. (2008). What we have learned about early childhood
and the development of delinquency. In A. Lieberman (Ed.), The long view
of crime: A synthesis of longitudinal research: Part II (pp. 79–127). New York:
Springer.
Sheeber, L., Hops, H., Alpert, A., Davis, B., & Andrews, J. (1997). Family support
and conflict: Prospective relations to adolescent depression. Journal of Abnor-
mal Child Psycholog y, 25, 333–344.
Sheeber, L., & Sorenson, E. (1998). Family relationships of depressed adolescents:
A multimethod assessment. Journal of Clinical Child Psychology, 27, 268–277.
Shirk, S. R., & Russell, R. L. (1996). Change processes in child psychotherapy: Revital-
izing treatment and research. New York: Guilford Press.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 156 7/22/2013 2:17:56 PM
Mindful Parenting 157
Sholevar, G. P. (2003). Family theory and therapy: An overview. In G. P. Sholevar
& L. D. Schwoeri (Eds.), Textbook of family and couples therapy: Clinical applica-
tions (pp. 3–28). Washington, DC: American Psychiatric Association.
Singh, N. N., Lancioni, G. E., Winton, A. S. W., Singh, J., Singh, A. N., Adkins,
A. D., et al. (2010). Training in mindful caregiving transfers to parent– child
interactions. Journal of Child and Family Studies, 19, 167–174.
Singh, N. N., Singh, A. N., Lancioni, G. E., Singh, J., Winton, A. S. W., & Adkins,
A. D. (2010). Mindfulness training for parents and their children with
ADHD increases the children’s compliance. Journal of Child and Family Stud-
ies, 19, 157–16 6.
Smith, C., & Farrington, D. (2004). Continuities in antisocial behavior and par-
enting across three generations. Journal of Child Psychology and Psychiatry, 45,
230–247.
Smith, J. D., Dishion, T. J., Moore, K. J., Shaw, D. S., & Wilson, M. N. (2013). Video
feedback in the Family Check-Up: Indirect effects on observed parent– child
coercive interactions. Journal of Clinical Child & Adolescent Psychology, 42(3),
40 5 – 417.
Smith, J. D., Dishion, T. J., Shaw, D. S., & Wilson, M. N. (in press). Indirect effects
of fidelity to the Family Check-Up on changes in parenting and early child-
hood problem behaviors. Journal of Consulting and Clinical Psychology.
Stark, K. D., Swearer, S., Kurowski, C., Sommer, D., & Bowen, B. (1996). Tar-
geting the child and the family: A holistic approach to treating child and
adolescent depressive disorders. In E. D. Hibbs & P. S. Jensen (Eds.), Psycho-
social treatments for child and adolescent disorders: Empirically based strategies
for clinical practice (pp. 207–238). Washington, DC: American Psychological
Association.
Steinberg, L. (2004). The 10 basic principles of good parenting. New York: Simon &
Schuster.
Stoolmiller, M., Duncan, T., Bank, L., & Patterson, G. R. (1993). Some problems
and solutions in the study of change: Significant patterns of client resis-
tance. Journal of Consulting and Clinical Psychology, 61, 920–928.
Stormshak, E. A., Bierman, K. L., McMahon, R. J., & Lengua, L. J. (2000). Par-
enting practices and child disruptive behavior problems in early elementary
school. Journal of Clinical Child Psycholog y, 29, 17–2 9.
Sugai, G., Horner, R. H., & Sprague, J. R. (1999). Functional- assessment- based
behavior support planning: Research to practice to research. Behavior Disor-
ders, 24, 253–257.
Tobler, A. L., & Komro, K. A. (2010). Trajectories of parental monitoring and
communication and effects on drug use among urban young adolescents.
Journal of Adolescent Health, 46, 560–568.
Vygotsky, L. (1986). Thought and language. Cambridge, MA: MIT Press.
Weaver, T. L., & Clum, G. A. (1993). Early family environments and traumatic
experiences associated with borderline personality disorder. Journal of Con-
sulting and Clinical Psychology, 61, 1068–1075.
Weisz, J. R., Huey, S. J., Jr., & Weersing, V. R. (1998). Psychotherapy outcome
research with children and adolescents: The state of the art. In T. H. Ollen-
dick & R. J. Prinz (Eds.), Advances in clinical child psychology (pp. 49–91). New
York: Plenum Press.
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 157 7/22/2013 2:17:56 PM
158 TRANSDIAGNOSTIC PROCESSES
Weisz, J. R., McCarty, C. A., & Valeri, S. M. (2006). Effects of psychotherapy for
depression in children and adolescents: A meta- analysis. Psychological Bul-
letin, 132, 132–149.
Whiting, B. B., & Edwards, C. P. (1988). Children of different worlds: The formation
of social behavior. Cambridge, MA: Harvard University Press.
Wood, J. J., McLeod, B. D., Sigman, M., Hwang, W., & Chu, B. C. (2003). Parent-
ing and childhood anxiety: Theory, empirical findings, and future direc-
tions. Journal of Child Psychology and Psychiatry, 44, 13 4 –151.
Woolfenden, S., Williams, K. J., & Peat, J. (2009). Family and parenting interven-
tions in children and adolescents with conduct disorder and delinquency
aged 10–17. Cochrane Database of Systematic Reviews, Issue 2 (Article No.
CD003015) .
Ehrenreich-May_TransdiagnsicTrtmntsChldrnAdolscnts.indb 158 7/22/2013 2:17:56 PM
