Evaluation of “The Incredible Years” in Sweden: The transferability of an American parent-training program to Sweden. Scandinavian Journal of Psychology, 53, 224-232

University of Gothenburg, Sweden.
Scandinavian Journal of Psychology (Impact Factor: 1.29). 06/2012; 53(3):224-32. DOI: 10.1111/j.1467-9450.2012.00955.x
Source: PubMed


Structured parent training has been proven to be effective in reducing disruptive behavior problems (DBP) in children. Most of the programs that are used in Sweden have their origin in North America, and there is an ongoing debate over the transferability to Sweden of manual-based programs developed in other contexts. The goal of the present study was to study effectiveness of the Incredible Years parent-training program (IY), developed in the US, in regular clinical work in Sweden, using a randomized controlled design. Parents of 62 four to eight-year-old children diagnosed with Oppositional Defiant Disorder participated in the study. Parents of 38 children were assigned to parent training (PT) and 24 to a waiting list (WL). The results indicate that the IYS retains the positive effects on children's disruptive behavior problems when translated and transferred to Swedish. There was a statistically significant difference in reduction of DBP in children between the groups in favor of the PT. The improvement in the PT group was sustained at the one-year follow-up. The improvement also, at least to some extent, generalized over time to the school context. There was also a statistically significant difference in mothers' report of pre to post change in parenting alliance between the PT and WL groups. The IYS program was appreciated and well received by the participating mothers.

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    • "Second, Incredible Years program has been widely evaluated by both the program developer (e.g., Menting, Orobio de Castro, & Matthys, 2013; Reid, Webster- Stratton, & Hammond, 2003; Webster-Stratton, Hollinsworth, & Kolpacoff, 1989) and independent researchers (Axberg & Broberg, 2012). The Swedish evaluation (Axberg & Broberg, 2012) reported large improvements in disruptive behaviors among the intervention group compared with a wait-list condition, and the improvements were retained over one year. The program effect on mothers' stress was small whereas the effects on parental control and perceived parent– child alliance were small to moderate. "
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    ABSTRACT: We evaluated the effectiveness of 4 parent-training programs for children with externalizing problems. We tested the effectiveness of 3 behavioral programs (Comet, Cope, and Incredible Years) and 1 nonbehavioral program (Connect) in reducing child behavior problems and attention-deficit/hyperactivity disorder (ADHD) symptoms, in improving positive parenting and parenting competence, and in decreasing negative parenting and parents' stress and depressive symptoms. This national study was designed as a randomized-controlled effectiveness trial (RCT). The treatments were carried out in 30 clinical and community-based practices. Parents of 908 children (ages 3-12 years) were randomly assigned to 1 of 2 parent training programs available at each practice, or to a wait-list condition, where parents had sought help from regular services. Before and after treatment, parents rated child behavior problems and parenting strategies. At posttreatment, children whose parents had received interventions showed a strong decrease in child conduct problems and a moderate to strong decrease in ADHD symptoms. About half of parents whose children scored over the 95th percentile on the behavior measures (Eyberg Child Behavior Inventory, Swanson, Nolan, and Pelham Rating Scale), a clinically meaningful cutoff, reported that their children were no longer above the cutoff after the intervention. Parents showed considerably less negative behaviors toward their children at posttest compared with pretest; they increased in parental competence, and decreased in both stress and depressive symptoms. Overall, the behavioral programs were more effective than the nonbehavioral program. The results support the general efficacy of parent training in a short-term perspective. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Full-text · Article · May 2015 · Journal of Consulting and Clinical Psychology
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    • "The current effectiveness study focuses on the extent to which a treatment can work in applied practice settings. In comparison to other effectiveness studies focused on treatment of youth with behavior disorders in community settings (Axberg and Broberg 2012; Behan et al. 2001; Costin and Chambers 2007; Gardner et al. 2006; Hagen et al. 2011; Hautmann et al. 2009; Kleve et al. 2010; Kling et al. 2010; Kjobli and Ogden 2013; Larsson et al. 2009; Ogden and Hagen 2008), the current study is unique as it has been conducted within typical inner-city community child mental health clinics within the US with a predominantly low-income sample. Effect sizes for between-group analyses in the current study are consistent with those reported for long-term follow-up among effectiveness studies we reviewed using an active, SAU control group, which is most similar to the current study. "
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    ABSTRACT: This paper reports on the 6-month follow-up outcomes of an effectiveness study testing a multiple family group (MFG) intervention for clinic-referred youth (aged 7–11) with disruptive behavior disorders (DBDs) and their families in socioeconomically disadvantaged families compared to services-as-usual (SAU) using a block comparison design. The settings were urban community-based outpatient mental health agencies. Clinic-based providers and family partner advocates facilitated the MFG intervention. Parent-report measures targeting child behavior, social skills, and impairment across functional domains (i.e., relationships with peers, parents, siblings, and academic progress) were assessed across four timepoints (baseline, mid-test, post-test, and 6-month follow-up) using mixed effects regression modeling. Compared to SAU participants, MFG participants reported significant improvement at 6-month follow-up in child behavior, impact of behavior on relationship with peers, and overall impairment/need for services. Findings indicate that MFG may provide longer-term benefits for youth with DBDs and their families in community-based settings. Implications within the context of a transforming healthcare system are discussed.
    Full-text · Article · Dec 2014 · Journal of Child and Family Studies
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    • "Because parent support programmes aim to change children's behaviour by promoting changes in parenting [2], a further inquiry into Swedish parenting practices is needed. Until there is sufficient evidence that parents and children in Sweden show similar behavioural dynamics as in other countries [12], evidence-based parenting programmes will not be made broadly available and public debate will continue to flare up over every new introduction of these programmes. In addition, since both mother and fathers are considered equal parents in Sweden, it is essential to include both parents in this study. "
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    ABSTRACT: Aims: We aim to examine the relationship between child behavioural problems and several parental factors, particularly parental behaviours as reported by both mothers and fathers in a sample of preschool children in Sweden. Methods: Participants were mothers and fathers of 504 3- to 5-year-olds that were recruited through preschools. They completed a set of questionnaires including the Eyberg Child Behavior Inventory, Parenting Sense of Competence Scale, Parenting Scale, Parent Problem Checklist, Dyadic Adjustment Scale and Depression Anxiety Stress Scale. Results: Correlational analyses showed that parent-reported child behaviour problems were positively associated with ineffective parenting practices and interparental conflicts and negatively related to parental competence. Regression analyses showed that, for both mothers and fathers, higher levels of parental over-reactivity and interparental conflict over child-rearing issues and lower levels of parental satisfaction were the most salient factors in predicting their reports of disruptive child behaviour. Conclusions: This study revealed that swedish parents' perceptions of their parenting is related to their ratings of child behaviour problems which therefore implies that parent training programs can be useful in addressing behavioural problems in Swedish children.
    Full-text · Article · Jul 2014 · Scandinavian Journal of Public Health
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